Provider First Line Business Practice Location Address:
252 NORTH MAIN STREET
Provider Second Line Business Practice Location Address:
EASTERN REHABILTITATION NETWORK 5TH FLOOR
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-643-3562
Provider Business Practice Location Address Fax Number:
860-643-3565
Provider Enumeration Date:
01/26/2006