Provider First Line Business Practice Location Address:
77 HERRICK ST
Provider Second Line Business Practice Location Address:
SUITE 201 COASTAL ORTHOPEDIC ASSOCIATES
Provider Business Practice Location Address City Name:
BEVERLY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-927-3040
Provider Business Practice Location Address Fax Number:
978-927-0443
Provider Enumeration Date:
10/27/2006