Provider First Line Business Practice Location Address:
129 S PLAINFIELD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH PLAINFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07080-4048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-755-1117
Provider Business Practice Location Address Fax Number:
908-755-8273
Provider Enumeration Date:
07/31/2006