Provider First Line Business Practice Location Address:
1018 N BETHLEHEM PIKE
Provider Second Line Business Practice Location Address:
SUITE C-2
Provider Business Practice Location Address City Name:
AMBLER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19002-2186
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-646-5990
Provider Business Practice Location Address Fax Number:
215-646-2901
Provider Enumeration Date:
05/20/2006