Provider First Line Business Practice Location Address:
400 KELBY ST
Provider Second Line Business Practice Location Address:
8TH FLOOR CLINICAL REVENUE OFFICE
Provider Business Practice Location Address City Name:
FORT LEE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07024-2943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-304-6408
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/29/2011