Provider First Line Business Practice Location Address:
399 N MARKET ST
Provider Second Line Business Practice Location Address:
WELLNESS CENTER
Provider Business Practice Location Address City Name:
SEAFORD
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19973-2611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-629-0884
Provider Business Practice Location Address Fax Number:
302-629-0886
Provider Enumeration Date:
08/29/2012