Provider First Line Business Practice Location Address:
800 SHOEMAKER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHOEMAKERSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19555-1635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-562-0437
Provider Business Practice Location Address Fax Number:
610-562-0522
Provider Enumeration Date:
07/14/2005