Provider First Line Business Practice Location Address:
RTE 940 AND 115 BLAKESLEE CORNERS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLAKESLEE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-643-7286
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2006