Provider First Line Business Practice Location Address:
RTE 202 AND 73
Provider Second Line Business Practice Location Address:
CENTER SQUARE PLAZA
Provider Business Practice Location Address City Name:
CENTER SQUARE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-279-9869
Provider Business Practice Location Address Fax Number:
610-279-9612
Provider Enumeration Date:
09/25/2006