Provider First Line Business Practice Location Address:
1006 N MILLS AVE
Provider Second Line Business Practice Location Address:
DESOTO MEMORIAL HOSPITAL
Provider Business Practice Location Address City Name:
ARCADIA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
863-494-5691
Provider Business Practice Location Address Fax Number:
863-494-8167
Provider Enumeration Date:
05/08/2007