Provider First Line Business Practice Location Address:
5365 LEHNENBERG RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINTNERSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18930-9706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-319-2394
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/29/2023