Provider First Line Business Practice Location Address:
16 COURTYARD OFFICES
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
SELINSGROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17870-9375
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-743-4000
Provider Business Practice Location Address Fax Number:
570-743-3105
Provider Enumeration Date:
07/08/2005