Provider First Line Business Practice Location Address:
209 ROBERTS ROAD
Provider Second Line Business Practice Location Address:
UNITED METHODIST HOME WESLEY VILLAGE
Provider Business Practice Location Address City Name:
PITTSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-655-2891
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/06/2012