Provider First Line Business Practice Location Address:
667 N 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:
18705-1013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-823-1111
Provider Business Practice Location Address Fax Number:
570-824-9044
Provider Enumeration Date:
02/09/2007