Provider First Line Business Practice Location Address:
ROUTE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MESHOPPEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-833-8300
Provider Business Practice Location Address Fax Number:
570-833-8310
Provider Enumeration Date:
08/18/2005