Provider First Line Business Practice Location Address:
115 S 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-2007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-917-1422
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2026