Provider First Line Business Practice Location Address:
88 WASHINGTON STRRET
Provider Second Line Business Practice Location Address:
ATTN EMERGENCY DEPT
Provider Business Practice Location Address City Name:
TANNTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-828-7108
Provider Business Practice Location Address Fax Number:
508-828-7158
Provider Enumeration Date:
11/07/2005