Provider First Line Business Practice Location Address:
30 MEDICAL CENTER BOULEVARD
Provider Second Line Business Practice Location Address:
PROFESSIONAL OFFICE BLDG 1, STE. 305
Provider Business Practice Location Address City Name:
UPLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-874-6448
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2013