Provider First Line Business Practice Location Address:
1955 U.S. 1 SOUTH, SUITE 200
Provider Second Line Business Practice Location Address:
ST. AUGUSTINE COMMUNITY BASED OUTPATIENT CLINIC/VETERAN
Provider Business Practice Location Address City Name:
ST. AUGUSTINE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32086
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-829-0814
Provider Business Practice Location Address Fax Number:
904-829-6174
Provider Enumeration Date:
02/06/2007