Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Aug 17, 2011
License(s)
OT014130 (PA), OS016752 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3760 BROOKSIDE RD | Macungie, PA 18062-1741 | 610-966-4646 |
| LOCATION | 3760 BROOKSIDE RD | Macungie, PA 18062-1741 | 610-966-4646 |
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