Provider First Line Business Practice Location Address:
850 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18052-5839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-807-4211
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2007