Provider First Line Business Practice Location Address:
565 MCELHATTAN DR
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:
17745-8360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-748-3590
Provider Business Practice Location Address Fax Number:
570-858-5083
Provider Enumeration Date:
11/01/2006