Provider First Line Business Practice Location Address:
256 SCHUYLER AVE STE 3
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:
18704-3322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-285-4299
Provider Business Practice Location Address Fax Number:
570-763-8135
Provider Enumeration Date:
05/21/2025