Provider First Line Business Practice Location Address:
100 W SPROUL ROAD
Provider Second Line Business Practice Location Address:
HEALTHPLEX PAVILION II - SUITE 100
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19064-2033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-690-4900
Provider Business Practice Location Address Fax Number:
610-690-1659
Provider Enumeration Date:
07/28/2005