Provider First Line Business Practice Location Address:
2536 MARTIN LUTHER KING JR. DR. SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-699-7774
Provider Business Practice Location Address Fax Number:
404-699-7716
Provider Enumeration Date:
07/23/2008