Provider First Line Business Practice Location Address:
200 SOUTH ORANGE AVE SUITE 102
Provider Second Line Business Practice Location Address:
AMBULATORY CARE CENTER
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07039-0703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
73-322-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2015