Provider First Line Business Practice Location Address:
212 SLATER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PATERSON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07501-2839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-881-1611
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2007