Provider First Line Business Practice Location Address:
1099 S TOWNSHIP BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JENKINS TWP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18640-3247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-654-6759
Provider Business Practice Location Address Fax Number:
570-655-5160
Provider Enumeration Date:
11/30/2007