Provider First Line Business Practice Location Address:
AGRICOLA ELEMENTARY SCHOOL
Provider Second Line Business Practice Location Address:
6165 HWY 613
Provider Business Practice Location Address City Name:
LUCEDALE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-947-8447
Provider Business Practice Location Address Fax Number:
601-947-8218
Provider Enumeration Date:
05/03/2007