Provider First Line Business Practice Location Address:
2 US-15
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENWOOD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-547-1990
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2018