Provider First Line Business Practice Location Address:
2400 MT ZION PARKWAY
Provider Second Line Business Practice Location Address:
SOUTHWOOD MEDICAL OFFICE
Provider Business Practice Location Address City Name:
JONESBORO
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-879-6120
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2007