Provider First Line Business Practice Location Address:
2552 ROUTE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAWLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18428-7045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-226-4557
Provider Business Practice Location Address Fax Number:
570-226-0838
Provider Enumeration Date:
06/07/2006