Provider First Line Business Practice Location Address:
12 DOUGLASSVILLE SHOPPING CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOUGLASSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19518-1543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-385-6643
Provider Business Practice Location Address Fax Number:
610-385-1712
Provider Enumeration Date:
07/20/2010