Provider First Line Business Practice Location Address:
581 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENNSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18073-1503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-679-9675
Provider Business Practice Location Address Fax Number:
215-679-5641
Provider Enumeration Date:
01/29/2007