Provider First Line Business Practice Location Address:
555 FOREST INN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-5254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-664-4065
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/03/2026