Provider First Line Business Practice Location Address:
6900 HAMILTON BOULEVARD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TREXLERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18089
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-402-0162
Provider Business Practice Location Address Fax Number:
610-402-0132
Provider Enumeration Date:
04/06/2007