Provider First Line Business Practice Location Address:
THE GRESS MOUNTAIN RANCH 3264 HIGHLAND ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OREFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18069-2606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-398-2122
Provider Business Practice Location Address Fax Number:
610-398-1363
Provider Enumeration Date:
09/15/2006