Provider First Line Business Practice Location Address:
80 METROPOLITAN AVE
Provider Second Line Business Practice Location Address:
#5R
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11211-3919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-596-1242
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/03/2011