Provider First Line Business Practice Location Address:
330 WOODSTOWN RD
Provider Second Line Business Practice Location Address:
MEDICAL ARTS BLDG 2
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-935-2577
Provider Business Practice Location Address Fax Number:
856-935-0726
Provider Enumeration Date:
08/11/2005