Provider First Line Business Practice Location Address:
125 E MAIN ST
Provider Second Line Business Practice Location Address:
1ST FLOOR OFFICE
Provider Business Practice Location Address City Name:
MACUNGIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18062-1310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-966-5111
Provider Business Practice Location Address Fax Number:
610-966-5484
Provider Enumeration Date:
09/20/2006