Provider First Line Business Practice Location Address:
119 SOUTH TURNPIKE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18414-9511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-563-3713
Provider Business Practice Location Address Fax Number:
570-563-3716
Provider Enumeration Date:
05/09/2007