Provider First Line Business Practice Location Address:
144 E NESHANNOCK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW WILMINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16142-1144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-656-1117
Provider Business Practice Location Address Fax Number:
724-656-1566
Provider Enumeration Date:
06/29/2006