Provider First Line Business Practice Location Address:
169 DELAWARE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALMERTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18071-1708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-826-5805
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2006