Provider First Line Business Practice Location Address:
489 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-4534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-283-0664
Provider Business Practice Location Address Fax Number:
570-283-5623
Provider Enumeration Date:
12/19/2006