Provider First Line Business Practice Location Address:
426 AIRPORT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAZLE TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18202-3361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-459-9730
Provider Business Practice Location Address Fax Number:
570-459-9736
Provider Enumeration Date:
06/20/2011