Provider First Line Business Practice Location Address:
155 SOUTH ARCH STREET
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MILTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17847-1172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-742-3014
Provider Business Practice Location Address Fax Number:
570-742-8318
Provider Enumeration Date:
04/04/2007