Provider First Line Business Practice Location Address:
2014 LAUBACH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18067-1357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-262-7811
Provider Business Practice Location Address Fax Number:
610-262-9216
Provider Enumeration Date:
05/25/2006