Provider First Line Business Practice Location Address:
750 STATE ROUTE 93
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SYBERTSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18251-0103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-708-2929
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/22/2008