Provider First Line Business Practice Location Address:
2843 STANLEY LAKE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRIENDSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18818-8768
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-553-1633
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/12/2008