Provider First Line Business Practice Location Address:
280 PIERCE ST
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:
18704-5136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-287-3009
Provider Business Practice Location Address Fax Number:
570-287-8698
Provider Enumeration Date:
01/27/2007