Provider First Line Business Practice Location Address:
4640 HIGH POINTE BLVD
Provider Second Line Business Practice Location Address:
SUITE 72
Provider Business Practice Location Address City Name:
SWATARA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17111-2463
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-724-1665
Provider Business Practice Location Address Fax Number:
717-724-1668
Provider Enumeration Date:
03/12/2008