Provider First Line Business Practice Location Address:
1125 N RIVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18702-1822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-825-5383
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006