Provider First Line Business Practice Location Address:
615 ROOSEVELT HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAYMART
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-488-7280
Provider Business Practice Location Address Fax Number:
570-488-6550
Provider Enumeration Date:
08/16/2006