Provider First Line Business Practice Location Address:
129 VALLEY VIEW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18426-4430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-676-8285
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2005