Provider First Line Business Practice Location Address:
964 AJAX STREET BRANCH HEALTH CLINIC - PRIMARY CARE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32214-3752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-353-8471
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2006