Provider First Line Business Practice Location Address:
2888 SR 29 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE TWP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18636-7854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-298-2161
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/13/2016