Provider First Line Business Practice Location Address:
382 PIERCE 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:
18704-5535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-288-7231
Provider Business Practice Location Address Fax Number:
570-331-4616
Provider Enumeration Date:
08/05/2009