Provider First Line Business Practice Location Address:
221 RIVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLYPHANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-383-3636
Provider Business Practice Location Address Fax Number:
570-383-3638
Provider Enumeration Date:
01/20/2006