Provider First Line Business Practice Location Address:
EMORY CRAWFORD LONG MOT
Provider Second Line Business Practice Location Address:
550 PEACHTREE ST NE
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-686-8114
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/23/2006