Provider First Line Business Practice Location Address:
130 POWERVILLE ROAD
Provider Second Line Business Practice Location Address:
ST CLARES HOSPITAL
Provider Business Practice Location Address City Name:
BOONTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-316-1905
Provider Business Practice Location Address Fax Number:
973-299-5466
Provider Enumeration Date:
03/21/2007