Provider First Line Business Practice Location Address:
64 INDUSTRIAL PARK ROAD
Provider Second Line Business Practice Location Address:
KENNEDY-DONOVAN CENTER INC
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02360-4829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-747-2012
Provider Business Practice Location Address Fax Number:
508-747-4898
Provider Enumeration Date:
03/24/2008