Provider First Line Business Practice Location Address:
18 KENNEDY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCHBALD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18403-1532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-876-1000
Provider Business Practice Location Address Fax Number:
570-876-6420
Provider Enumeration Date:
11/21/2006