Provider First Line Business Practice Location Address:
255 W LANCASTER AVE
Provider Second Line Business Practice Location Address:
PAOLI MEDICAL BLDG 3 SUITE 234
Provider Business Practice Location Address City Name:
PAOLI
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-647-4260
Provider Business Practice Location Address Fax Number:
610-647-7430
Provider Enumeration Date:
06/13/2006