Provider First Line Business Practice Location Address:
1525 N CHURCH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAZLE TWP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18202-9383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-454-5222
Provider Business Practice Location Address Fax Number:
570-454-5967
Provider Enumeration Date:
06/26/2006