Provider First Line Business Practice Location Address:
550 3RD AVE
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-5806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-283-3300
Provider Business Practice Location Address Fax Number:
570-331-7129
Provider Enumeration Date:
05/22/2007