Provider First Line Business Practice Location Address:
819 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18052-6623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-264-3251
Provider Business Practice Location Address Fax Number:
610-264-5040
Provider Enumeration Date:
07/31/2006