Provider First Line Business Practice Location Address:
4945 NOR BATH BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18067-9705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-344-1918
Provider Business Practice Location Address Fax Number:
610-261-1271
Provider Enumeration Date:
12/27/2005