Provider First Line Business Practice Location Address:
203 S GLORIA ST
Provider Second Line Business Practice Location Address:
HENDRY REGIONAL CORP HEALTH
Provider Business Practice Location Address City Name:
CLEWISTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
863-983-1123
Provider Business Practice Location Address Fax Number:
863-983-1137
Provider Enumeration Date:
08/09/2007