Provider First Line Business Practice Location Address:
593 EDDY ST
Provider Second Line Business Practice Location Address:
APC 6 - DEPARTMENT OF NEUROSURGERY
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-485-6509
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2019