Provider First Line Business Practice Location Address:
980 US HIGHWAY 9
Provider Second Line Business Practice Location Address:
SUITE C, 2ND FLOOR
Provider Business Practice Location Address City Name:
SOUTH AMBOY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08879-3320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-753-9888
Provider Business Practice Location Address Fax Number:
732-753-9889
Provider Enumeration Date:
06/03/2013