Provider First Line Business Practice Location Address:
401-403 HAZLE TOWNSHIP BOULEVARD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAZLE TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18202-9604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-454-8888
Provider Business Practice Location Address Fax Number:
570-454-4190
Provider Enumeration Date:
12/11/2014