Provider First Line Business Practice Location Address:
1850 S TOWNSHIP BLVD
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
PITTSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-654-1641
Provider Business Practice Location Address Fax Number:
570-654-2835
Provider Enumeration Date:
08/13/2006