Provider First Line Business Practice Location Address:
V.A. MEDICAL CENTER
Provider Second Line Business Practice Location Address:
1670 CLAIRMONT RD.
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30033-4098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-321-6111
Provider Business Practice Location Address Fax Number:
404-417-2912
Provider Enumeration Date:
06/29/2006