Provider First Line Business Practice Location Address:
384 COUNTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02740-4980
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-993-3127
Provider Business Practice Location Address Fax Number:
508-993-5278
Provider Enumeration Date:
10/04/2005