Provider First Line Business Practice Location Address:
400 BROOKSBY VILLAGE DR
Provider Second Line Business Practice Location Address:
ATTN: EXTENDED CARE ADMINISTRATOR
Provider Business Practice Location Address City Name:
PEABODY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01960-1488
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-536-2150
Provider Business Practice Location Address Fax Number:
410-204-7237
Provider Enumeration Date:
01/12/2006