| Provider Type: | Other Service Providers |
| Provider Classification: | Specialist |
| Definition of Specialization: | |
| Address: |
406 S Deane Duff Ave Clewiston, FL 33440-3818 |
| Phone: | (863) 983-5453 |
| Fax: | (863) 983-2059 |
| Gender: | Male |
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