Provider First Line Business Practice Location Address:
158 E BUTLER AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
AMBLER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19002-4436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-760-9797
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2005