Provider First Line Business Practice Location Address:
173 POINT TOWNSHIP DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHUMBERLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17857-8889
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-473-7506
Provider Business Practice Location Address Fax Number:
570-473-7262
Provider Enumeration Date:
03/30/2007