Provider First Line Business Practice Location Address:
459 HIGHWAY 119 S
Provider Second Line Business Practice Location Address:
PHYSICIAN CENTER OFFICE
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-352-8700
Provider Business Practice Location Address Fax Number:
912-650-6805
Provider Enumeration Date:
04/17/2008