Provider First Line Business Practice Location Address:
196 WEST SPROUL ROAD
Provider Second Line Business Practice Location Address:
HEALTH PLEX SUITE 205
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-604-0888
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/29/2008