Provider First Line Business Practice Location Address:
33 E 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WYOMING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18644-2006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-693-1371
Provider Business Practice Location Address Fax Number:
570-613-9224
Provider Enumeration Date:
11/01/2006