Provider First Line Business Practice Location Address:
681 ROUTE 15 SOUTH
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:
07849-2038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-663-0800
Provider Business Practice Location Address Fax Number:
973-663-0103
Provider Enumeration Date:
06/15/2006