Provider First Line Business Practice Location Address:
1018 BETHLEHEM PK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGHOUSE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-646-0486
Provider Business Practice Location Address Fax Number:
215-646-9362
Provider Enumeration Date:
11/28/2005