Provider First Line Business Practice Location Address:
8 OAK GROVE RD
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
PINE GROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17963-1226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-345-3321
Provider Business Practice Location Address Fax Number:
570-345-6470
Provider Enumeration Date:
02/23/2006