Provider First Line Business Practice Location Address:
417 PENNSYLVANIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AVONDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19311-1120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-268-8122
Provider Business Practice Location Address Fax Number:
610-268-3103
Provider Enumeration Date:
05/08/2008