Provider First Line Business Practice Location Address:
185 ROSEBERRY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILLIPSBURG
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08865-1690
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-346-7797
Provider Business Practice Location Address Fax Number:
510-342-9802
Provider Enumeration Date:
11/04/2005