Provider First Line Business Practice Location Address:
BUILDING 5203 MARYLAND AVENUE
Provider Second Line Business Practice Location Address:
ARMY SUBSTANCE ABUSE PROGRAM
Provider Business Practice Location Address City Name:
FORT DIX
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-562-4011
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2006