Provider First Line Business Practice Location Address:
45 HOWARD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LARKSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-1413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-283-2867
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2007