Provider First Line Business Practice Location Address:
560 MCELHATTAN DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOCK HAVEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-263-4042
Provider Business Practice Location Address Fax Number:
570-769-5022
Provider Enumeration Date:
07/06/2012