Provider First Line Business Practice Location Address:
575 SOUTH 9TH STREET
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-645-1035
Provider Business Practice Location Address Fax Number:
570-645-1036
Provider Enumeration Date:
02/01/2007