Provider First Line Business Practice Location Address:
208 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOSCOW
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18444-9135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-842-9323
Provider Business Practice Location Address Fax Number:
570-842-9362
Provider Enumeration Date:
10/22/2014