Organization
SMART OF SOUTH JERSEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY J COSLOP JR. (EXECUTIVE)
(609) 904-3456
Entity
Organization
Contact information
Practice address
304 JOSEPH AVE, LINWOOD, NJ 08221-1519
(609) 904-3456
(609) 788-4100
Mailing address
304 JOSEPH AVE, LINWOOD, NJ 08221-1519
(609) 904-3456
(609) 788-4100
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
11/23/2015
Last updated
11/23/2015
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