Provider First Line Business Practice Location Address:
2544 PLAINFIELD AVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
SCOTCH PLAINS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07076-2058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-232-3363
Provider Business Practice Location Address Fax Number:
908-232-3369
Provider Enumeration Date:
12/15/2010