Provider First Line Business Practice Location Address:
127 S 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUAKERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18951-1680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-529-9998
Provider Business Practice Location Address Fax Number:
215-525-9666
Provider Enumeration Date:
12/24/2009