Provider First Line Business Practice Location Address:
50 MEMORIAL BLVD
Provider Second Line Business Practice Location Address:
AQUIDNECK MEDICAL ASSOCIATES, INC
Provider Business Practice Location Address City Name:
NEWPORT
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02840-3587
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-847-2290
Provider Business Practice Location Address Fax Number:
401-849-8446
Provider Enumeration Date:
06/30/2005