Provider First Line Business Practice Location Address:
3281 VALLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FISHERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15539-9843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-839-4195
Provider Business Practice Location Address Fax Number:
814-839-9137
Provider Enumeration Date:
04/26/2006