Provider First Line Business Practice Location Address:
400 SOUTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CATAWISSA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17820-1043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-204-4695
Provider Business Practice Location Address Fax Number:
570-356-2765
Provider Enumeration Date:
01/04/2007