Provider First Line Business Practice Location Address:
38 MEDICAL ARTS CENTER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31405-4155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-692-0755
Provider Business Practice Location Address Fax Number:
912-692-0754
Provider Enumeration Date:
11/30/2007