Provider First Line Business Practice Location Address:
706 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREELAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18224-1915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-636-0480
Provider Business Practice Location Address Fax Number:
570-636-0508
Provider Enumeration Date:
10/20/2006