Provider First Line Business Practice Location Address:
220 S RIVER ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18705-1137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-287-1301
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2005