Provider First Line Business Practice Location Address:
1325 RALPH DAVID ABERNATHY BLVD. SW
Provider Second Line Business Practice Location Address:
JENCARE NEIGHBORHOOD MEDICAL CENTER WEST END, LLC
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30310-1649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-836-0136
Provider Business Practice Location Address Fax Number:
404-753-5269
Provider Enumeration Date:
05/25/2006