Provider First Line Business Practice Location Address:
67 UNIVERSITY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNMORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18512-1604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-436-1626
Provider Business Practice Location Address Fax Number:
570-689-6749
Provider Enumeration Date:
03/10/2009