Provider First Line Business Practice Location Address:
20 NORTH 23 STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT PENN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-779-7444
Provider Business Practice Location Address Fax Number:
610-779-4818
Provider Enumeration Date:
11/03/2006