Provider First Line Business Practice Location Address:
82 68 164TH ST
Provider Second Line Business Practice Location Address:
OWENS HOSPITAL CENTER DEPT OF REHAB
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-883-4313
Provider Business Practice Location Address Fax Number:
718-883-6142
Provider Enumeration Date:
04/25/2006