Provider First Line Business Practice Location Address:
1738 ROUTE 31 NORTH
Provider Second Line Business Practice Location Address:
CENTER FOR ADVANCED WEIGHT LOSS
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08809-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-735-3915
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/06/2007