Provider First Line Business Practice Location Address:
27241 STATE ROUTE 267
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRIENDSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18818-8640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-231-2422
Provider Business Practice Location Address Fax Number:
607-231-2422
Provider Enumeration Date:
01/11/2013