Provider First Line Business Practice Location Address:
55 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:
570-523-3264
Provider Business Practice Location Address Fax Number:
570-523-3465
Provider Enumeration Date:
09/26/2005