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1003557224
MINI MINE LLC
LAKEWOOD, NJ
NPI
1003557224
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Entity Type
Organization
Authorized Contact
MALKA NUSSBAUM
Clinical Director
732-886-8113
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
Enumeration Date
2022-04-03
Last Update Date
2024-06-17
Business Address
MINI MINE LLC
128 MELVILLE AVE
LAKEWOOD, NJ 08701-4235
Phone number: 732-886-8113
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Mailing Address
MINI MINE LLC
128 MELVILLE AVE
LAKEWOOD, NJ 08701-4235
Phone number: 732-886-8113
Copy
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