Provider First Line Business Practice Location Address:
701 COLUMBIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALMERTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18071-1403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-328-3742
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2008