Provider First Line Business Practice Location Address:
480 DELAWARE AVE
Provider Second Line Business Practice Location Address:
BOX D
Provider Business Practice Location Address City Name:
PALMERTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18071-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-769-4111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2014