Provider First Line Business Practice Location Address:
821 N BETHLEHEM PK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING HOUSE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-643-9003
Provider Business Practice Location Address Fax Number:
215-643-9006
Provider Enumeration Date:
06/26/2006