Provider First Line Business Practice Location Address:
710 BRIDGE STREET, SUITE 204
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-377-1228
Provider Business Practice Location Address Fax Number:
866-723-5249
Provider Enumeration Date:
08/03/2006