Provider First Line Business Practice Location Address:
380 RAILROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOREST CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18421-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-785-5025
Provider Business Practice Location Address Fax Number:
570-785-2369
Provider Enumeration Date:
06/25/2010