Provider First Line Business Practice Location Address:
NORTHEAST PREMIER PHYSICAL MEDICINE, LLC
Provider Second Line Business Practice Location Address:
151 NEW PARK AVENUE, STE 4
Provider Business Practice Location Address City Name:
HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-232-1576
Provider Business Practice Location Address Fax Number:
860-432-8669
Provider Enumeration Date:
05/03/2007