Provider First Line Business Practice Location Address:
101 S MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
COOPERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18036-1965
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-776-4746
Provider Business Practice Location Address Fax Number:
610-776-4904
Provider Enumeration Date:
01/15/2015