Provider First Line Business Practice Location Address:
1114 E CATAWISSA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NESQUEHONING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18240-1805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-645-1920
Provider Business Practice Location Address Fax Number:
570-645-1925
Provider Enumeration Date:
07/14/2008