Provider First Line Business Practice Location Address:
10 HOSPITAL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARBONDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18407-1848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-858-7796
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/28/2025