Provider First Line Business Practice Location Address:
601 8TH ST
Provider Second Line Business Practice Location Address:
BMA OF FULLERTON - CKD SERVICES
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18052-5701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-266-5811
Provider Business Practice Location Address Fax Number:
610-266-5815
Provider Enumeration Date:
06/07/2006