Provider First Line Business Practice Location Address:
2310 KNAPP ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11229-5924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-513-6178
Provider Business Practice Location Address Fax Number:
718-513-6179
Provider Enumeration Date:
02/27/2012