Provider First Line Business Practice Location Address:
206 SOUTH STREET
Provider Second Line Business Practice Location Address:
SMR HEALTH CARE
Provider Business Practice Location Address City Name:
FAIRFIELD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-255-3367
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2005