Provider First Line Business Practice Location Address:
211 N. 12TH STREET
Provider Second Line Business Practice Location Address:
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:
610-377-7354
Provider Business Practice Location Address Fax Number:
610-377-7920
Provider Enumeration Date:
01/03/2011