Provider First Line Business Practice Location Address:
574 VALLEY ST
Provider Second Line Business Practice Location Address:
HEALTH DEPT
Provider Business Practice Location Address City Name:
MAPLEWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07040-2669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-762-8120
Provider Business Practice Location Address Fax Number:
973-762-2805
Provider Enumeration Date:
11/14/2007