Provider First Line Business Practice Location Address: 
INTERNATIONAL EMERGENCY MEDICINE
    Provider Second Line Business Practice Location Address: 
75 FRANCIS ST
    Provider Business Practice Location Address City Name: 
BOSTON
    Provider Business Practice Location Address State Name: 
MA
    Provider Business Practice Location Address Postal Code: 
02115
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
617-732-5813
    Provider Business Practice Location Address Fax Number: 
617-713-3060
    Provider Enumeration Date: 
04/25/2006