Provider First Line Business Practice Location Address:
ROUTE 15, 2 MILES NORTH OF ALLENWOOD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE DEER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17887-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-547-7950
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/02/2018