Provider First Line Business Practice Location Address:
4500 WEST MIDWAY RD
Provider Second Line Business Practice Location Address:
NEW HORIZONS OF THE TREASURE COAST
Provider Business Practice Location Address City Name:
FORT PIERCE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34981
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-672-8480
Provider Business Practice Location Address Fax Number:
772-467-5522
Provider Enumeration Date:
06/11/2013