Provider First Line Business Practice Location Address:
5074 KERNSVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OREFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18069-2320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-395-1993
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2009