Provider First Line Business Practice Location Address:
2015 UPPER GATE DR NE
Provider Second Line Business Practice Location Address:
DIVISION OF NEONATOLOGY, 3RD FLOOR
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30322-1014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-727-3360
Provider Business Practice Location Address Fax Number:
404-727-3236
Provider Enumeration Date:
07/19/2007