Provider First Line Business Practice Location Address:
232 S GERMAN ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUSHORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18614-7891
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-928-8618
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2016