Provider First Line Business Practice Location Address:
240 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLEBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17842-1147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-837-3940
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2007