Provider First Line Business Practice Location Address:
220 S RIVER ST
Provider Second Line Business Practice Location Address:
SUITE 200
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:
570-824-8151
Provider Business Practice Location Address Fax Number:
570-824-0111
Provider Enumeration Date:
10/13/2006