Provider First Line Business Practice Location Address:
3424 HWY 252 EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOLKSTON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-496-6025
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2006