Provider First Line Business Practice Location Address:
7200 HWY. 441 NORTH
Provider Second Line Business Practice Location Address:
ECKERD YOUTH DEVELOPMENT CENTER
Provider Business Practice Location Address City Name:
OKEECHOBEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34972
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
863-763-2174
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2006