Provider First Line Business Practice Location Address:
420 FRANTZ RD
Provider Second Line Business Practice Location Address:
SALESIAN MONASTERY
Provider Business Practice Location Address City Name:
BRODHEADSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18322-7722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-992-3448
Provider Business Practice Location Address Fax Number:
570-992-3448
Provider Enumeration Date:
04/10/2006