Provider First Line Business Practice Location Address:
330 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DICKSON CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18519-1691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-330-5180
Provider Business Practice Location Address Fax Number:
570-330-5024
Provider Enumeration Date:
05/04/2022