Provider First Line Business Practice Location Address:
590 PALMYRA TWNSHIP/RTE 6/ LAKE REGION CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAWLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-226-6550
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/09/2024