Provider First Line Business Practice Location Address:
400 RTE 17
Provider Second Line Business Practice Location Address:
C/O ONE BODY WELLNESS
Provider Business Practice Location Address City Name:
RIDGEWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07450-2010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-615-7585
Provider Business Practice Location Address Fax Number:
201-493-7034
Provider Enumeration Date:
08/28/2009