Provider First Line Business Practice Location Address:
1000 JOHNSON FERRY ROAD NE
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE AT NORTHSIDE HOSPITAL
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-603-1303
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2010