Provider First Line Business Practice Location Address:
1401 FAIRMONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18052-6051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-432-4122
Provider Business Practice Location Address Fax Number:
610-432-6677
Provider Enumeration Date:
07/10/2006