Provider First Line Business Practice Location Address:
515 JERSEYTOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17846-8825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-458-5597
Provider Business Practice Location Address Fax Number:
570-458-5114
Provider Enumeration Date:
01/05/2015