Provider First Line Business Practice Location Address:
214 LUMBER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGHSPIRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17034-1307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-306-8137
Provider Business Practice Location Address Fax Number:
888-530-0962
Provider Enumeration Date:
04/20/2006