Provider First Line Business Practice Location Address:
80 MEDICAL PARK DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17837-9387
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-523-1163
Provider Business Practice Location Address Fax Number:
570-524-5737
Provider Enumeration Date:
08/18/2009