Provider First Line Business Practice Location Address:
200 BLOOMFIELD AVENUE
Provider Second Line Business Practice Location Address:
PROHEALTH PHYSICIANS STUDENT HEALTH SERVICES
Provider Business Practice Location Address City Name:
WEST HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-768-6601
Provider Business Practice Location Address Fax Number:
860-768-5140
Provider Enumeration Date:
11/24/2009