Provider First Line Business Practice Location Address:
305 BLACK ROCK TPKE
Provider Second Line Business Practice Location Address:
ORTHPAEDIC SPECIALTY GROUP, PC
Provider Business Practice Location Address City Name:
FAIRFIELD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06825-5508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-337-2600
Provider Business Practice Location Address Fax Number:
203-337-2666
Provider Enumeration Date:
12/19/2007