Provider First Line Business Practice Location Address:
FORT HEALTH MEDICAL GROUP 613 WASHING BLVD.
Provider Second Line Business Practice Location Address:
#1297
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
10314-1509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-208-2616
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2012