Provider First Line Business Practice Location Address:
1322 OLD TREXLERTOWN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TREXLERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18087-0792
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-739-0258
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2009