Provider First Line Business Practice Location Address:
102 STATE ROUTE 611
Provider Second Line Business Practice Location Address:
BARTONSVILLE COMMONS SUITE #4
Provider Business Practice Location Address City Name:
BARTONSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-629-8001
Provider Business Practice Location Address Fax Number:
570-629-8821
Provider Enumeration Date:
04/18/2007