Provider First Line Business Practice Location Address:
575 SOUTH 9TH STREET
Provider Second Line Business Practice Location Address:
SUITE 7
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-1218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-645-1000
Provider Business Practice Location Address Fax Number:
570-645-1001
Provider Enumeration Date:
03/09/2017