Provider First Line Business Practice Location Address:
423 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLEBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17842-1215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-837-0112
Provider Business Practice Location Address Fax Number:
570-837-3587
Provider Enumeration Date:
08/08/2006