Provider First Line Business Practice Location Address:
549 E. BRAMBLETON AVE
Provider Second Line Business Practice Location Address:
JENCARE NEIGHBORHOOD MEDICAL NORFOLK, LLC
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-533-9441
Provider Business Practice Location Address Fax Number:
757-446-1454
Provider Enumeration Date:
11/11/2010