Provider First Line Business Practice Location Address:
5074 KERNSVILLE RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OREFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18069-0267
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-366-8637
Provider Business Practice Location Address Fax Number:
610-366-7745
Provider Enumeration Date:
04/27/2007