Provider First Line Business Practice Location Address:
2013 PONCE DE LEON AVE
Provider Second Line Business Practice Location Address:
PAL BEACH PATHOLOGY PA
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33411-6019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-659-0770
Provider Business Practice Location Address Fax Number:
561-802-3504
Provider Enumeration Date:
11/14/2005