Provider First Line Business Practice Location Address:
140 DECATUR STREET
Provider Second Line Business Practice Location Address:
PHYSICAL THERAPY DEPARTMENT
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-747-1821
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2007