Provider First Line Business Practice Location Address:
781 EDGEWOOD AVE N
Provider Second Line Business Practice Location Address:
UFJP COMMONWEALTH FAMILY PRACTICE
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-633-0500
Provider Business Practice Location Address Fax Number:
904-384-4663
Provider Enumeration Date:
03/26/2008