Provider First Line Business Practice Location Address:
127 S 5TH ST
Provider Second Line Business Practice Location Address:
SUITE 180
Provider Business Practice Location Address City Name:
QUAKERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18951
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-538-9440
Provider Business Practice Location Address Fax Number:
215-538-1613
Provider Enumeration Date:
12/27/2006