Provider First Line Business Practice Location Address:
516 IRON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-1913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-377-5155
Provider Business Practice Location Address Fax Number:
610-377-5576
Provider Enumeration Date:
12/22/2005