Provider First Line Business Practice Location Address:
267 GRANT ST
Provider Second Line Business Practice Location Address:
BRIDGEPORT HOSPITAL
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-384-3801
Provider Business Practice Location Address Fax Number:
203-384-4619
Provider Enumeration Date:
10/08/2008