Provider First Line Business Practice Location Address:
856 46TH ST
Provider Second Line Business Practice Location Address:
C/O THERAPY IN MOTION
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11220-1656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-910-8801
Provider Business Practice Location Address Fax Number:
888-241-5730
Provider Enumeration Date:
08/25/2009