Provider First Line Business Practice Location Address:
3749 RIVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUMBERVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18933-9715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-297-5869
Provider Business Practice Location Address Fax Number:
215-297-5869
Provider Enumeration Date:
02/27/2010