Provider First Line Business Practice Location Address:
145 E 9TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERWICK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18603-3132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-759-1239
Provider Business Practice Location Address Fax Number:
570-759-1230
Provider Enumeration Date:
02/22/2006