Provider First Line Business Practice Location Address:
260 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILL HALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17751-1707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-726-3213
Provider Business Practice Location Address Fax Number:
570-726-3020
Provider Enumeration Date:
09/30/2015