Provider First Line Business Practice Location Address:
200 STATE HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17821-9103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-271-4500
Provider Business Practice Location Address Fax Number:
570-271-4537
Provider Enumeration Date:
10/18/2006