Provider First Line Business Practice Location Address:
ROUTES 940 & 115
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLAKESLEE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-646-8745
Provider Business Practice Location Address Fax Number:
570-646-8962
Provider Enumeration Date:
06/26/2006