Provider First Line Business Practice Location Address:
346 1ST ST
Provider Second Line Business Practice Location Address:
C/O HOME THERAPY PT LLC
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11215-1906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-708-9701
Provider Business Practice Location Address Fax Number:
347-708-9701
Provider Enumeration Date:
12/04/2006