Provider First Line Business Practice Location Address:
216 N 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EMMAUS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18049-2718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-762-9565
Provider Business Practice Location Address Fax Number:
610-682-0820
Provider Enumeration Date:
05/21/2013