Provider First Line Business Practice Location Address:
201 MAIN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STOCKERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18083
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-746-3000
Provider Business Practice Location Address Fax Number:
610-746-3000
Provider Enumeration Date:
01/12/2006