Provider First Line Business Practice Location Address:
694 STATE ROUTE 15 S STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE HOPATCONG
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07849-2249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-288-1550
Provider Business Practice Location Address Fax Number:
973-288-1552
Provider Enumeration Date:
11/08/2010