Provider First Line Business Practice Location Address:
1592 ROUTE 739
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DINGMANS FERRY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-253-6551
Provider Business Practice Location Address Fax Number:
570-253-6553
Provider Enumeration Date:
10/18/2010