Provider First Line Business Practice Location Address:
1745 PEACHTREE ST NE
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE BROOKWOOD MEDICAL CENTER
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30309-2410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-389-2727
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2016