Provider First Line Business Practice Location Address:
417 BALTIMORE PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19064-3810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-470-2600
Provider Business Practice Location Address Fax Number:
610-273-5520
Provider Enumeration Date:
12/28/2005