Provider First Line Business Practice Location Address:
7 DOCK HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLEBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17842-8910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-837-6617
Provider Business Practice Location Address Fax Number:
570-837-6417
Provider Enumeration Date:
12/20/2005