Provider First Line Business Practice Location Address:
400 E 2ND ST
Provider Second Line Business Practice Location Address:
324 KEHR UNION BUILDING
Provider Business Practice Location Address City Name:
BLOOMSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17815-1301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-389-4451
Provider Business Practice Location Address Fax Number:
570-389-3417
Provider Enumeration Date:
02/22/2006