Provider First Line Business Practice Location Address:
417 NORTH MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-888-8886
Provider Business Practice Location Address Fax Number:
570-888-8876
Provider Enumeration Date:
09/15/2006