Provider First Line Business Practice Location Address:
142 JORALEMON ST FL 2
Provider Second Line Business Practice Location Address:
IRMACAMPBELL01@GMAIL.COM
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-200-3331
Provider Business Practice Location Address Fax Number:
516-630-3574
Provider Enumeration Date:
08/08/2025