Provider First Line Business Practice Location Address:
2021 STATE ROUTE 35
Provider Second Line Business Practice Location Address:
REHAB DEPARTMENT
Provider Business Practice Location Address City Name:
WALL TOWNSHIP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07719-3539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-539-1730
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2007