Provider First Line Business Practice Location Address:
246 GRANDVIEW ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH ABINGTON TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18411-8975
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-586-9471
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2006