Provider First Line Business Practice Location Address:
980 JOHNSON FERRY RD NE
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE HOSPITAL SERVICES SUITE 570
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30342-1626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-225-0215
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006