Provider First Line Business Practice Location Address:
2516 LANTERN CT S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MACUNGIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18062-9792
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-217-4123
Provider Business Practice Location Address Fax Number:
610-395-9008
Provider Enumeration Date:
12/14/2006