Provider First Line Business Practice Location Address:
50 W RIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANSFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18232-1342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-656-3095
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2011