Provider First Line Business Practice Location Address:
60 LAFAYETTE ST
Provider Second Line Business Practice Location Address:
CHIROPRACTIC CLINIC
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06604-7719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-576-4347
Provider Business Practice Location Address Fax Number:
203-576-4250
Provider Enumeration Date:
12/29/2008