Provider First Line Business Practice Location Address:
3032 N. SUSQUEHANNA TRAIL
Provider Second Line Business Practice Location Address:
ROUTES 11 AND 15
Provider Business Practice Location Address City Name:
SHAMOKIN DAM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17876-0429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-743-5020
Provider Business Practice Location Address Fax Number:
570-743-4505
Provider Enumeration Date:
04/09/2007