Provider First Line Business Practice Location Address:
672 N RIVER ST
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18705-1014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-829-0880
Provider Business Practice Location Address Fax Number:
570-829-0889
Provider Enumeration Date:
02/06/2009