Provider First Line Business Practice Location Address:
299 WYOMING AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WYOMING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18644-1620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-693-3480
Provider Business Practice Location Address Fax Number:
570-693-1508
Provider Enumeration Date:
02/21/2007