Provider First Line Business Practice Location Address:
6 MILLBROOK PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILL HALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17751-1911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-748-1130
Provider Business Practice Location Address Fax Number:
570-748-1126
Provider Enumeration Date:
07/09/2006