Provider First Line Business Practice Location Address:
21 S ZELLERS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC CLURE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17841-9722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-415-0510
Provider Business Practice Location Address Fax Number:
570-415-0511
Provider Enumeration Date:
03/15/2010