Provider First Line Business Practice Location Address:
41 PHILADELPHIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUNKHANNOCK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18657-1200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-836-8207
Provider Business Practice Location Address Fax Number:
570-836-7205
Provider Enumeration Date:
06/04/2006