Provider First Line Business Practice Location Address:
1112 BETHEL CHURCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19475-9652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-495-5429
Provider Business Practice Location Address Fax Number:
610-495-5429
Provider Enumeration Date:
03/23/2007