Provider First Line Business Practice Location Address:
320 E WATER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOCK HAVEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17745-1410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-748-4131
Provider Business Practice Location Address Fax Number:
570-748-2095
Provider Enumeration Date:
04/28/2008