Provider First Line Business Practice Location Address:
1088 SR 307 STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FACTORYVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18419-7877
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-378-1000
Provider Business Practice Location Address Fax Number:
570-378-2012
Provider Enumeration Date:
06/28/2013