Provider First Line Business Practice Location Address:
149 ANDREAS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANDREAS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18211-3003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-386-2947
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2009