Provider First Line Business Practice Location Address:
2020 ELMWOOD AVENUE
Provider Second Line Business Practice Location Address:
KENTHOUSE INC
Provider Business Practice Location Address City Name:
WARWICK
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02888
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-781-2700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2006