Provider First Line Business Practice Location Address:
762 STATE HWY 15
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE HOPATCONG
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07438
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-663-3002
Provider Business Practice Location Address Fax Number:
973-663-4894
Provider Enumeration Date:
08/10/2005