Provider First Line Business Practice Location Address:
3 HOSPITAL DR
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
LEWISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17837-9362
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-522-9771
Provider Business Practice Location Address Fax Number:
570-522-9772
Provider Enumeration Date:
07/19/2006