Provider First Line Business Practice Location Address:
2400 MOUNT ZION PKWY
Provider Second Line Business Practice Location Address:
KP SOUTHWOOD MEDICAL CENTER
Provider Business Practice Location Address City Name:
JONESBORO
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30236-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-603-3572
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/18/2006