Provider First Line Business Practice Location Address:
1 HIGHLAND BLVD S
Provider Second Line Business Practice Location Address:
209
Provider Business Practice Location Address City Name:
ARCHBALD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18403-1516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-258-5475
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/09/2026