Provider First Line Business Practice Location Address:
253 OWEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SWOYERSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-2207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-287-8360
Provider Business Practice Location Address Fax Number:
570-718-6503
Provider Enumeration Date:
11/07/2006