Provider First Line Business Practice Location Address:
6714 LOWER MACUNGIE RD
Provider Second Line Business Practice Location Address:
APT K-6
Provider Business Practice Location Address City Name:
TREXLERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18087-9701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-374-0132
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/22/2016