Provider First Line Business Practice Location Address:
59 FRANKLIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUNKHANNOCK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18657-1414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-836-0193
Provider Business Practice Location Address Fax Number:
570-836-6131
Provider Enumeration Date:
01/31/2013