Provider First Line Business Practice Location Address:
254 S MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUGHESVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17737-1614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-584-5144
Provider Business Practice Location Address Fax Number:
570-584-5416
Provider Enumeration Date:
04/19/2007