Provider First Line Business Practice Location Address:
512 CANAL STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLEMINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17745-3714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-748-9022
Provider Business Practice Location Address Fax Number:
570-748-0174
Provider Enumeration Date:
05/15/2007