Provider First Line Business Practice Location Address:
115 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17837-2201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-523-3004
Provider Business Practice Location Address Fax Number:
570-523-0030
Provider Enumeration Date:
03/30/2007