Provider First Line Business Practice Location Address:
2340 PA ROUTE 309
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OREFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-398-2058
Provider Business Practice Location Address Fax Number:
610-398-2058
Provider Enumeration Date:
11/16/2006