Provider First Line Business Practice Location Address:
903 CENTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JIM THORPE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-325-8300
Provider Business Practice Location Address Fax Number:
570-325-0272
Provider Enumeration Date:
09/12/2006