Provider First Line Business Practice Location Address:
UNIVERSITY OF BRIDGEPORT
Provider Second Line Business Practice Location Address:
120 WALDEMERE AVENUE
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-576-4936
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/01/2007