Provider First Line Business Practice Location Address:
104 MIDSTREAMS ROAD
Provider Second Line Business Practice Location Address:
BRICK PSYCHOTHERAPY CENTER
Provider Business Practice Location Address City Name:
BRICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08724-3725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-477-6400
Provider Business Practice Location Address Fax Number:
732-295-9515
Provider Enumeration Date:
04/12/2007