Provider First Line Business Practice Location Address:
117 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18706-2323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-824-1009
Provider Business Practice Location Address Fax Number:
570-824-1037
Provider Enumeration Date:
10/20/2006