Provider First Line Business Practice Location Address:
1600 SW ARCHER ROAD
Provider Second Line Business Practice Location Address:
ATTN: DANIEL COUSIN, M.D. DEPART. RADIOLOGY
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32610-0374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-303-3125
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2008