Provider First Line Business Practice Location Address:
389 MILLER 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:
18709-1502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-899-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2026