Provider First Line Business Practice Location Address:
281 N 12TH ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-1101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-377-7793
Provider Business Practice Location Address Fax Number:
484-403-4015
Provider Enumeration Date:
05/10/2006