Provider First Line Business Practice Location Address:
333 WEST LOCKHART STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAYRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18840-1695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-888-4892
Provider Business Practice Location Address Fax Number:
570-888-8248
Provider Enumeration Date:
10/23/2006