Provider First Line Business Practice Location Address:
110 S. 1ST STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-2031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-377-3940
Provider Business Practice Location Address Fax Number:
610-377-4026
Provider Enumeration Date:
04/15/2009