Provider First Line Business Practice Location Address:
504 1/2 SCRANTON CARBONDALE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAYFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-498-6858
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/16/2018