Provider First Line Business Practice Location Address:
3487 NW 30TH ST
Provider Second Line Business Practice Location Address:
ST ANTHONY'S REHABILITATION HOSPITAL
Provider Business Practice Location Address City Name:
LAUDERDALE LAKES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33311-1103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-739-6233
Provider Business Practice Location Address Fax Number:
954-343-3484
Provider Enumeration Date:
11/07/2005