Provider First Line Business Practice Location Address:
N ACADEMY AVE
Provider Second Line Business Practice Location Address:
OR PHARMACY 42-01
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17822-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-271-6907
Provider Business Practice Location Address Fax Number:
570-271-5839
Provider Enumeration Date:
08/27/2008