Provider First Line Business Practice Location Address:
2183 MACDADE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLMES
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19043-1210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-461-6371
Provider Business Practice Location Address Fax Number:
484-494-5879
Provider Enumeration Date:
07/23/2026