Provider First Line Business Practice Location Address:
403 BETHEL RD
Provider Second Line Business Practice Location Address:
C/O JERSEY UROLOGY GROUP P. A.
Provider Business Practice Location Address City Name:
SOMERS POINT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08244-2188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-927-8746
Provider Business Practice Location Address Fax Number:
609-601-1406
Provider Enumeration Date:
12/22/2009