Provider First Line Business Practice Location Address:
EMORY UNIV HOSP DEPT OF UROLOGY
Provider Second Line Business Practice Location Address:
STE B1400 1365 CLIFTON RD NE
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30322-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-778-4615
Provider Business Practice Location Address Fax Number:
404-778-4231
Provider Enumeration Date:
04/07/2011