Provider First Line Business Practice Location Address:
ONE NORMAL AVE
Provider Second Line Business Practice Location Address:
MONTCLAIR STATE UNIVERSITY HEALTH CENTER
Provider Business Practice Location Address City Name:
MONTCLAIR
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
974-655-4361
Provider Business Practice Location Address Fax Number:
973-655-4159
Provider Enumeration Date:
04/12/2007