Provider First Line Business Practice Location Address:
116 S. OAK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT. CARMEL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-339-2100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2008