Provider First Line Business Practice Location Address:
10 PROSPECT ST
Provider Second Line Business Practice Location Address:
C/O ORTHO CARE, INC
Provider Business Practice Location Address City Name:
WESTFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07090-2114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-232-9910
Provider Business Practice Location Address Fax Number:
908-232-9915
Provider Enumeration Date:
12/09/2012