Provider First Line Business Practice Location Address:
12110 MORRIS BRIGE ROAD
Provider Second Line Business Practice Location Address:
3RD FLOOR THERAPY SUITE
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-550-1212
Provider Business Practice Location Address Fax Number:
813-867-7177
Provider Enumeration Date:
05/05/2015