Provider First Line Business Practice Location Address:
3540 OLD PHILADELPHIA PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INTERCOURSE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17534-7008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-456-7027
Provider Business Practice Location Address Fax Number:
610-424-7614
Provider Enumeration Date:
10/27/2005