Provider First Line Business Practice Location Address:
538 S STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17846-9219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-458-5573
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2005