Provider First Line Business Practice Location Address:
100 N ACADEMY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17822-6804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-271-6393
Provider Business Practice Location Address Fax Number:
570-271-5623
Provider Enumeration Date:
04/24/2008