Provider First Line Business Practice Location Address:
135 LAFAYETTE 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:
18071-1518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-822-5320
Provider Business Practice Location Address Fax Number:
484-822-5321
Provider Enumeration Date:
11/03/2006