Provider First Line Business Practice Location Address:
50 W 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT CARMEL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17851-1354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-339-5024
Provider Business Practice Location Address Fax Number:
570-339-2953
Provider Enumeration Date:
02/22/2006