Provider First Line Business Practice Location Address:
2142 WEST BROAD STREET, BUILDING 200
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE ATHENS MEDICAL CENTER
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-583-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2008