Provider First Line Business Practice Location Address:
1104 6TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CATASAUQUA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18032-2210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-264-3344
Provider Business Practice Location Address Fax Number:
610-264-2081
Provider Enumeration Date:
08/03/2006