Provider First Line Business Practice Location Address:
205 MAIN ST. 1ST FL
Provider Second Line Business Practice Location Address:
OPTIMUM MEDICAL LLC
Provider Business Practice Location Address City Name:
DANBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-794-9000
Provider Business Practice Location Address Fax Number:
203-794-9005
Provider Enumeration Date:
07/04/2006