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Organization

RELIANCE ASPEN AVIDON LLC

Active
Other names
Lice Lifters NJ
Organization subpart
No

Provider details

NPI number
Authorized official
LISA R RAFAL (OWNER)
(732) 540-8145
Entity
Organization

Contact information

Practice address
1119 RARITAN RD, SUITE 2, CLARK, NJ 07066-1315
(732) 540-8145
Mailing address
1245 SUNNYFIELD LN, SCOTCH PLAINS, NJ 07076-2219
(908) 499-2519

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Enumeration date
09/27/2012
Last updated
09/27/2012
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