Provider First Line Business Practice Location Address:
144 SUNSET AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENFIELD TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18407-3730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-499-4340
Provider Business Practice Location Address Fax Number:
570-499-4340
Provider Enumeration Date:
11/25/2025