Provider First Line Business Practice Location Address:
37-28 77TH STREET
Provider Second Line Business Practice Location Address:
REST MEDICAL CARE
Provider Business Practice Location Address City Name:
JACKSON HEIGHTS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11372-6630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-335-7378
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/10/2013