Provider First Line Business Practice Location Address:
934 MILFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DINGMANS FERRY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18328-9629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-828-2351
Provider Business Practice Location Address Fax Number:
570-828-6319
Provider Enumeration Date:
01/25/2007