Provider First Line Business Practice Location Address:
2869 WILSHIRE D
Provider Second Line Business Practice Location Address:
TRICOUNTY PSYCHIATRIC ASSOCIATES, P.A..
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-578-6200
Provider Business Practice Location Address Fax Number:
407-578-3977
Provider Enumeration Date:
02/15/2007