Provider First Line Business Practice Location Address:
361 S 11TH ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
QUAKERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18951-1414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-538-1999
Provider Business Practice Location Address Fax Number:
215-538-9004
Provider Enumeration Date:
03/24/2006