Provider First Line Business Practice Location Address:
750 E DELAWARE AVENUE
Provider Second Line Business Practice Location Address:
NEWARK HIGH SCHOOL
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19711-7185
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-369-1606
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2006