Provider First Line Business Practice Location Address:
1933 STATE ROUTE 29
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNLOCK CREEK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18621-4228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-341-9340
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2007