Provider First Line Business Practice Location Address:
LUTHERAN PARISH HALL (SECOND FLOOR)
Provider Second Line Business Practice Location Address:
51 KING STREET
Provider Business Practice Location Address City Name:
CHRISTIANSTED
Provider Business Practice Location Address State Name:
VI
Provider Business Practice Location Address Postal Code:
00820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
340-626-7972
Provider Business Practice Location Address Fax Number:
340-778-3573
Provider Enumeration Date:
04/20/2007