Provider First Line Business Practice Location Address:
77 HERRICK ST
Provider Second Line Business Practice Location Address:
STE 101 THE MEDICAL GROUP INC
Provider Business Practice Location Address City Name:
BEVERLY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01915-3012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-927-4110
Provider Business Practice Location Address Fax Number:
978-232-7057
Provider Enumeration Date:
12/31/2007