Provider First Line Business Practice Location Address:
BRIGHTON AND BOARDWALK
Provider Second Line Business Practice Location Address:
TROPICANA MEDICAL UNIT
Provider Business Practice Location Address City Name:
ATLANTIC CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-340-4475
Provider Business Practice Location Address Fax Number:
609-343-5205
Provider Enumeration Date:
01/22/2007