Provider First Line Business Practice Location Address:
281 N 12TH ST
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-442-4436
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/29/2012