Provider First Line Business Practice Location Address:
701 BRIDGE ST
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:
18235-1800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-377-6155
Provider Business Practice Location Address Fax Number:
610-377-9765
Provider Enumeration Date:
06/27/2006