Provider First Line Business Practice Location Address:
NEW JERSEY AVE
Provider Second Line Business Practice Location Address:
WALSON TROOP MEDICAL CLINIC BLDG 5250
Provider Business Practice Location Address City Name:
FORT DIX
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-562-5707
Provider Business Practice Location Address Fax Number:
609-562-3153
Provider Enumeration Date:
03/16/2006