Provider First Line Business Practice Location Address:
71 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOWANDA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18848-9702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-265-6300
Provider Business Practice Location Address Fax Number:
570-268-2807
Provider Enumeration Date:
12/21/2010