Provider First Line Business Practice Location Address:
140 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUZERNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18709-1273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-362-2348
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2021