Provider First Line Business Practice Location Address:
2020 59TH ST W
Provider Second Line Business Practice Location Address:
BLAKE HOSPITAL PATHOLOGY
Provider Business Practice Location Address City Name:
BRADENTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34209-4604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-798-6176
Provider Business Practice Location Address Fax Number:
941-798-6168
Provider Enumeration Date:
04/22/2006