Provider First Line Business Practice Location Address:
EIGHTH AND ALABAMA
Provider Second Line Business Practice Location Address:
OUTPATIENT CLINIC AT MARSHALL HALL
Provider Business Practice Location Address City Name:
FORT STDIX
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-562-2999
Provider Business Practice Location Address Fax Number:
609-562-5426
Provider Enumeration Date:
10/23/2006