Provider First Line Business Practice Location Address:
HC #1 BOX 30
Provider Second Line Business Practice Location Address:
BUSINESS ROUTE 209 & BOSSARDVILLE RD
Provider Business Practice Location Address City Name:
SCIOTA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-992-6300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/14/2008