Provider First Line Business Practice Location Address:
525 IRON ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
LEHIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18235-1949
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-379-4677
Provider Business Practice Location Address Fax Number:
610-379-4678
Provider Enumeration Date:
09/02/2015