Provider First Line Business Practice Location Address:
694 RT 15 S. PLAZA
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
LAKE HOPATCONG
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-288-1550
Provider Business Practice Location Address Fax Number:
973-288-1552
Provider Enumeration Date:
07/13/2006