Provider First Line Business Practice Location Address:
RT 29 AND RT 3023
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DIMOCK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18816-0163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-278-2882
Provider Business Practice Location Address Fax Number:
570-278-2422
Provider Enumeration Date:
12/20/2006