Provider First Line Business Practice Location Address:
75 PINEAPPLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NUREMBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-704-4235
Provider Business Practice Location Address Fax Number:
570-763-4493
Provider Enumeration Date:
09/30/2019