Provider First Line Business Practice Location Address:
70 N CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARBONDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18407-1912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-281-6300
Provider Business Practice Location Address Fax Number:
570-281-6301
Provider Enumeration Date:
06/16/2017