Provider First Line Business Practice Location Address:
1832 COUNTY ROUTE 565
Provider Second Line Business Practice Location Address:
VERNON TOWNSHIP HIGH SCHOOL
Provider Business Practice Location Address City Name:
VERNON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-764-2995
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006