Provider First Line Business Practice Location Address:
126 WARREN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUNKHANNOCK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18657-1300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-996-9600
Provider Business Practice Location Address Fax Number:
570-996-9614
Provider Enumeration Date:
05/15/2008