Provider First Line Business Practice Location Address:
2195 RT 442 HWY SUITE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUNCY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17756-9801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-546-5200
Provider Business Practice Location Address Fax Number:
570-546-7409
Provider Enumeration Date:
07/17/2006