Provider First Line Business Practice Location Address:
3615 STATE ROUTE 28 AND 66
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16242-8107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-275-2264
Provider Business Practice Location Address Fax Number:
814-690-7875
Provider Enumeration Date:
11/01/2006