Provider First Line Business Practice Location Address:
FLOWERFIELD BLDG 17
Provider Second Line Business Practice Location Address:
PEDERSON KRAG CONTINUED DAY TREATMENT
Provider Business Practice Location Address City Name:
SAINT JAMES
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-920-8599
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/01/2007