Provider First Line Business Practice Location Address:
3089 BRIGHTON 3 STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-332-5555
Provider Business Practice Location Address Fax Number:
718-332-8204
Provider Enumeration Date:
08/29/2007