Provider First Line Business Practice Location Address:
30 PITTSTOWN ROAD
Provider Second Line Business Practice Location Address:
EDNA MAHAN CORRECTIONAL FACILITY FOR WOMEN
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-735-7111
Provider Business Practice Location Address Fax Number:
908-730-6788
Provider Enumeration Date:
09/11/2006