Provider First Line Business Practice Location Address:
430 S. 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-1824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-377-5177
Provider Business Practice Location Address Fax Number:
610-377-5099
Provider Enumeration Date:
01/25/2006