Provider First Line Business Practice Location Address:
2 SHARPE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-3715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-491-0126
Provider Business Practice Location Address Fax Number:
570-230-0013
Provider Enumeration Date:
07/15/2020