Provider First Line Business Practice Location Address:
PEMA, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE
Provider Second Line Business Practice Location Address:
1001 JOHNSON FERRY ROAD
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-938-0772
Provider Business Practice Location Address Fax Number:
770-621-9230
Provider Enumeration Date:
04/26/2006