Provider First Line Business Practice Location Address:
430 COUNTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02740-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-996-2112
Provider Business Practice Location Address Fax Number:
508-990-0666
Provider Enumeration Date:
08/30/2006