Provider First Line Business Practice Location Address:
603 W LOCKHART ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAYRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18840-1314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-423-1249
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2021