Provider First Line Business Practice Location Address:
3229 BEAR RUN BLVD
Provider Second Line Business Practice Location Address:
CLAY COUNTY HEALTH DEPT -BLDG A
Provider Business Practice Location Address City Name:
ORANGE PARK
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-213-3202
Provider Business Practice Location Address Fax Number:
904-272-4353
Provider Enumeration Date:
02/21/2006