Provider First Line Business Practice Location Address:
1138 WEST MAIN ST
Provider Second Line Business Practice Location Address:
ADVANCED SOLUTIONS THERAPY CENTER LLC
Provider Business Practice Location Address City Name:
WATERBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-755-0707
Provider Business Practice Location Address Fax Number:
203-755-9275
Provider Enumeration Date:
03/15/2007