Provider First Line Business Practice Location Address:
152 CHESTNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19475-1803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-374-3634
Provider Business Practice Location Address Fax Number:
610-792-3652
Provider Enumeration Date:
07/29/2011