Provider First Line Business Practice Location Address:
1618 SCHADT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18052-3702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-351-6337
Provider Business Practice Location Address Fax Number:
610-351-6338
Provider Enumeration Date:
10/15/2018