Provider First Line Business Practice Location Address:
575 S 9TH ST STE 1
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:
18235-2517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-645-1990
Provider Business Practice Location Address Fax Number:
570-645-1995
Provider Enumeration Date:
01/29/2015