Provider First Line Business Practice Location Address:
129 S MAIN ST STE T
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044-2386
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-538-1240
Provider Business Practice Location Address Fax Number:
570-538-1257
Provider Enumeration Date:
03/21/2024