Provider First Line Business Practice Location Address:
298 7TH AVE
Provider Second Line Business Practice Location Address:
STOREFRONT
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11215-3621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-547-4306
Provider Business Practice Location Address Fax Number:
718-896-5565
Provider Enumeration Date:
01/13/2009