Provider First Line Business Practice Location Address:
531 N FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHAMOKIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17872-6754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-486-4588
Provider Business Practice Location Address Fax Number:
570-486-4590
Provider Enumeration Date:
03/22/2022