Provider First Line Business Practice Location Address:
2968 ELMIRA ST
Provider Second Line Business Practice Location Address:
VALLEY SHOPPING PLAZA
Provider Business Practice Location Address City Name:
SAYRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18840-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-888-7516
Provider Business Practice Location Address Fax Number:
570-882-9630
Provider Enumeration Date:
03/17/2010