Provider First Line Business Practice Location Address:
424 ROUTE 106
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENFIELD TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18407-3904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-282-4981
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2006