Provider First Line Business Practice Location Address:
3950 AUSTELL RD
Provider Second Line Business Practice Location Address:
INPATIENT REHAB UNIT/3 NORTH
Provider Business Practice Location Address City Name:
AUSTELL
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30106-1121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
470-644-0012
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2005