Provider First Line Business Practice Location Address:
2416 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18052-4822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-264-2188
Provider Business Practice Location Address Fax Number:
610-264-3391
Provider Enumeration Date:
03/24/2006