Provider First Line Business Practice Location Address:
1204 SR 307
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FACTORYVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18419-7880
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-378-2000
Provider Business Practice Location Address Fax Number:
570-378-3763
Provider Enumeration Date:
03/15/2007