Provider First Line Business Practice Location Address:
74 KING ST
Provider Second Line Business Practice Location Address:
HEALTH SERVICES
Provider Business Practice Location Address City Name:
ST AUGUSTINE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32084-4342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-819-6211
Provider Business Practice Location Address Fax Number:
904-824-1183
Provider Enumeration Date:
06/26/2012