Provider First Line Business Practice Location Address:
260 GRAYSON ROAD
Provider Second Line Business Practice Location Address:
JEWISH FAMILY SERVICE OF TIDEWATER INC
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
23462-4345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-459-4640
Provider Business Practice Location Address Fax Number:
757-459-4643
Provider Enumeration Date:
12/06/2006