Provider First Line Business Practice Location Address:
AUTUMN LAKE HEALTHCARE
Provider Second Line Business Practice Location Address:
400 BRITTANY FARMS RD
Provider Business Practice Location Address City Name:
NEW BRITAIN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-905-1980
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/30/2008