Provider First Line Business Practice Location Address:
190 S 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:
18705-1149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-970-1400
Provider Business Practice Location Address Fax Number:
570-970-1403
Provider Enumeration Date:
11/16/2005