Provider First Line Business Practice Location Address:
210 LEWIS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILLIPSBURG
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08865-2961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
862-214-5552
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/07/2026