Provider First Line Business Practice Location Address:
MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
E SMITHFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18817-0066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-596-7600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2006