Provider First Line Business Practice Location Address:
142 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOSCOW
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18444-9149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-780-5004
Provider Business Practice Location Address Fax Number:
570-457-0189
Provider Enumeration Date:
09/03/2013