Provider First Line Business Practice Location Address:
809 BETHLEHEM PIKE
Provider Second Line Business Practice Location Address:
BOX 129
Provider Business Practice Location Address City Name:
SPRING HOUSE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-643-7944
Provider Business Practice Location Address Fax Number:
215-643-9543
Provider Enumeration Date:
05/11/2007