Provider First Line Business Practice Location Address:
1548 DEKALB ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORRISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19401-3425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-279-2828
Provider Business Practice Location Address Fax Number:
610-275-0633
Provider Enumeration Date:
11/02/2005