Provider First Line Business Practice Location Address:
520 CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SWOYERSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-2950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-704-8639
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2024