Provider First Line Business Practice Location Address:
75 MEDICAL PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17837-6343
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-374-8555
Provider Business Practice Location Address Fax Number:
570-374-9933
Provider Enumeration Date:
07/20/2006