Provider First Line Business Practice Location Address:
99 BEAUVOIR AVENUE
Provider Second Line Business Practice Location Address:
ATLANTIC BRAIN & SPINE INSTITUTE
Provider Business Practice Location Address City Name:
SUMMIT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-522-4979
Provider Business Practice Location Address Fax Number:
908-522-5377
Provider Enumeration Date:
10/10/2006