Provider First Line Business Practice Location Address:
11 HAP AMOLD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOBYHANNA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18466
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-895-7225
Provider Business Practice Location Address Fax Number:
570-895-6783
Provider Enumeration Date:
09/22/2006