Provider First Line Business Practice Location Address:
220 BOARDMAN BUILDING
Provider Second Line Business Practice Location Address:
PLASTIC AND RECONSTRUCTIVE SURGERY
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-785-2570
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2007