Provider First Line Business Practice Location Address:
60 GLENMAURA NATIONAL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOOSIC
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18507-2101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-301-5000
Provider Business Practice Location Address Fax Number:
570-704-5073
Provider Enumeration Date:
04/15/2020