Provider First Line Business Practice Location Address:
18 NORTH MAIN STREET
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:
18706-2246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-820-3366
Provider Business Practice Location Address Fax Number:
570-820-7795
Provider Enumeration Date:
05/22/2007