Provider First Line Business Practice Location Address:
1115 WEST CALL STREET
Provider Second Line Business Practice Location Address:
FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE
Provider Business Practice Location Address City Name:
TALLAHASSEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32306-4300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-644-8477
Provider Business Practice Location Address Fax Number:
850-644-9399
Provider Enumeration Date:
03/25/2006