Provider First Line Business Practice Location Address:
236 PENNSYLVANIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILL HALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17751-1829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-726-4988
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/23/2009