Provider First Line Business Practice Location Address:
180 NORTH MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PICTURE ROCKS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17762-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-584-4115
Provider Business Practice Location Address Fax Number:
570-584-2492
Provider Enumeration Date:
10/28/2005