Provider First Line Business Practice Location Address:
311 STATE ROUTE 93
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORANGEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17859-9001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-441-4859
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/17/2026