Provider First Line Business Practice Location Address:
175 NORTHUMBERLAND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17822-9737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-284-4575
Provider Business Practice Location Address Fax Number:
570-284-4577
Provider Enumeration Date:
11/12/2010