Provider First Line Business Practice Location Address:
4201 KUTZTOWN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEMPLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-921-2094
Provider Business Practice Location Address Fax Number:
610-921-1235
Provider Enumeration Date:
07/16/2006