Provider First Line Business Practice Location Address:
279 NEW BRITAIN RD, #6
Provider Second Line Business Practice Location Address:
ORIGINS OF HEALTH, LLC
Provider Business Practice Location Address City Name:
BERLIN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-438-7096
Provider Business Practice Location Address Fax Number:
860-438-7134
Provider Enumeration Date:
01/21/2008