Provider First Line Business Practice Location Address:
60 HODGES AVENUE
Provider Second Line Business Practice Location Address:
TAUNTON STATE HOSPITAL
Provider Business Practice Location Address City Name:
TAUNTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02780-0997
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-977-3332
Provider Business Practice Location Address Fax Number:
508-977-3751
Provider Enumeration Date:
03/27/2006