Provider First Line Business Practice Location Address:
4200 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COAL TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17866-9668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-644-6109
Provider Business Practice Location Address Fax Number:
570-644-4363
Provider Enumeration Date:
11/01/2010