Provider First Line Business Practice Location Address:
100 KENYON AVE
Provider Second Line Business Practice Location Address:
SOUTH COUNTY HOSPITAL
Provider Business Practice Location Address City Name:
WAKEFIELD
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-782-8020
Provider Business Practice Location Address Fax Number:
401-788-3113
Provider Enumeration Date:
12/29/2006