Provider First Line Business Practice Location Address:
34 S KENNEDY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCADOO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18237-1806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-929-2042
Provider Business Practice Location Address Fax Number:
570-929-1153
Provider Enumeration Date:
11/23/2005