Provider First Line Business Practice Location Address:
1201 N CHURCH ST STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAZLE TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18202-1453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-454-7546
Provider Business Practice Location Address Fax Number:
215-482-7548
Provider Enumeration Date:
06/20/2006