Provider First Line Business Practice Location Address:
185 POWERS ST
Provider Second Line Business Practice Location Address:
#3
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11211-4921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-683-4239
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2013