Provider First Line Business Practice Location Address:
345 BLACKSTONE BLVD
Provider Second Line Business Practice Location Address:
BUTLER HOSPITAL, PSYCH RESIDENCY PROGRAM, DUNCAN E-160
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02906-4800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-455-6200
Provider Business Practice Location Address Fax Number:
491-455-6497
Provider Enumeration Date:
06/09/2013