Provider First Line Business Practice Location Address:
MMC - FAMILY CARE CENTER
Provider Second Line Business Practice Location Address:
3444 KOSSUTH AVE. 1ST FL. RM B
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-920-5873
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/08/2006