Provider First Line Business Practice Location Address:
13,000 BRUCE B. DOWNS B
Provider Second Line Business Practice Location Address:
JAMES A. HALEY VETERANS HOSPITAL #11-C
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33612-4745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-972-7510
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/05/2006