Provider First Line Business Practice Location Address:
UVA ENT CLINIC AT FONTAINE
Provider Second Line Business Practice Location Address:
415 RAY C. HUNT DRIVE
Provider Business Practice Location Address City Name:
CHARLOTTESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-924-5700
Provider Business Practice Location Address Fax Number:
434-293-0883
Provider Enumeration Date:
03/28/2007