Provider First Line Business Practice Location Address: 
100 QUALITY ST
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
TRUMBULL
    Provider Business Practice Location Address State Name: 
CT
    Provider Business Practice Location Address Postal Code: 
06611-3100
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
203-261-3691
    Provider Business Practice Location Address Fax Number: 
203-261-0167
    Provider Enumeration Date: 
07/07/2006