Provider First Line Business Practice Location Address:
143 N 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-1512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-377-0450
Provider Business Practice Location Address Fax Number:
610-377-1551
Provider Enumeration Date:
10/26/2006