Provider First Line Business Practice Location Address:
448 CHAMBERLAIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PATERSON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07522-1009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-942-8296
Provider Business Practice Location Address Fax Number:
973-942-1213
Provider Enumeration Date:
02/20/2007