Provider First Line Business Practice Location Address:
552 SMITHBRIDGE RD
Provider Second Line Business Practice Location Address:
GARNET VALLEY HIGH SCHOOL
Provider Business Practice Location Address City Name:
GLEN MILLS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19342-1558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-579-7757
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2006