Provider First Line Business Practice Location Address:
761 WALTHER ROAD COMPREHENSIVE PRIMARY CARE, LLC
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LAWRENCEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-888-2273
Provider Business Practice Location Address Fax Number:
678-888-2273
Provider Enumeration Date:
09/07/2016