Provider First Line Business Practice Location Address:
8235 SCHANTZ RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
BREINIGSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18031-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-530-5702
Provider Business Practice Location Address Fax Number:
610-530-5755
Provider Enumeration Date:
04/13/2010