Provider First Line Business Practice Location Address:
101 S MORTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUTLEDGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19070-2025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-543-4331
Provider Business Practice Location Address Fax Number:
610-543-4331
Provider Enumeration Date:
02/19/2006