Provider First Line Business Practice Location Address:
1145 KEMPTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02740-1531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-999-3241
Provider Business Practice Location Address Fax Number:
508-996-5440
Provider Enumeration Date:
11/17/2020