Provider First Line Business Practice Location Address:
220 FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNMORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18512-2364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-688-4112
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2009