Provider First Line Business Practice Location Address:
281.N.12TH STREET.
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-377-6969
Provider Business Practice Location Address Fax Number:
610-377-9099
Provider Enumeration Date:
04/10/2007