Provider First Line Business Practice Location Address:
2270 KIMBALL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11234-5139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-252-0570
Provider Business Practice Location Address Fax Number:
718-253-3421
Provider Enumeration Date:
11/10/2006