Provider First Line Business Practice Location Address:
28 N 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17837-1567
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-230-7629
Provider Business Practice Location Address Fax Number:
570-522-9308
Provider Enumeration Date:
04/01/2016