Provider First Line Business Practice Location Address:
415 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BERLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17855-8058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-966-2552
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/24/2008