Provider First Line Business Practice Location Address:
600 GREEN ACRES RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17814-7603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-925-0944
Provider Business Practice Location Address Fax Number:
570-925-5020
Provider Enumeration Date:
04/24/2006