Provider First Line Business Practice Location Address:
2560 MILL CREEK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MACUNGIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18062-8824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-221-3717
Provider Business Practice Location Address Fax Number:
610-351-1158
Provider Enumeration Date:
08/23/2005