Provider First Line Business Practice Location Address:
15 ALLIANCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17959-1101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-127-7621
Provider Business Practice Location Address Fax Number:
570-277-6398
Provider Enumeration Date:
02/26/2009