Provider First Line Business Practice Location Address:
UMDNJ / UNIVERSITY CORRECTIONAL HC C/O NJDOC
Provider Second Line Business Practice Location Address:
COLPITTS MODULAR UNIT, BOX 863 ,WHITTLESEY RD.
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-341-3093
Provider Business Practice Location Address Fax Number:
609-341-9380
Provider Enumeration Date:
10/02/2007