Provider First Line Business Practice Location Address:
2314 E BUCK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENNSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18073-2327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-300-2144
Provider Business Practice Location Address Fax Number:
267-923-5020
Provider Enumeration Date:
03/12/2007