Provider First Line Business Practice Location Address:
502 N BALTIMORE AVE
Provider Second Line Business Practice Location Address:
BUILDING A, SUITE 2
Provider Business Practice Location Address City Name:
MOUNT HOLLY SPRINGS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17065-1602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-313-9400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2015