Provider First Line Business Practice Location Address:
118 SOMERSET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREEMANSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-7258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-614-1220
Provider Business Practice Location Address Fax Number:
610-614-1224
Provider Enumeration Date:
03/05/2007