Provider First Line Business Practice Location Address:
1057 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:
18032-2238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-264-9801
Provider Business Practice Location Address Fax Number:
610-264-0564
Provider Enumeration Date:
10/03/2006