Provider First Line Business Practice Location Address:
500 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEATHERLY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18255-1506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-427-8643
Provider Business Practice Location Address Fax Number:
570-427-8044
Provider Enumeration Date:
11/10/2005