Provider First Line Business Practice Location Address:
639 N SOUTH TURNPIKE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWFOUNDLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18445-5032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-839-6151
Provider Business Practice Location Address Fax Number:
570-676-4586
Provider Enumeration Date:
12/31/2019