Provider First Line Business Practice Location Address:
120 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATSONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17777-1723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-538-1488
Provider Business Practice Location Address Fax Number:
570-538-1599
Provider Enumeration Date:
02/08/2022