Provider First Line Business Practice Location Address:
454 W VALLEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELYSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17824-7247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-672-1111
Provider Business Practice Location Address Fax Number:
570-672-1100
Provider Enumeration Date:
10/23/2014