Provider First Line Business Practice Location Address: 
253 GORDON'S CORNER ROAD
    Provider Second Line Business Practice Location Address: 
MINUTE CLINIC
    Provider Business Practice Location Address City Name: 
MANALAPAN
    Provider Business Practice Location Address State Name: 
NJ
    Provider Business Practice Location Address Postal Code: 
07726
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
732-888-8299
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
08/27/2014