Provider First Line Business Practice Location Address:
119 LAMSDEN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBRIGHTSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18210-7004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-977-2411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2019