Provider First Line Business Practice Location Address:
2360 ROUTE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OREFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18069-3121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-398-2180
Provider Business Practice Location Address Fax Number:
610-398-1528
Provider Enumeration Date:
11/20/2006