Provider First Line Business Practice Location Address:
522 OLD COLONY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH ABINGTON TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18411-1604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-357-6956
Provider Business Practice Location Address Fax Number:
570-586-2910
Provider Enumeration Date:
06/17/2020