Provider First Line Business Practice Location Address:
1325 N RIVER ST
Provider Second Line Business Practice Location Address:
TUF-TEX PLAZA
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18702-1838
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-824-0039
Provider Business Practice Location Address Fax Number:
570-824-6922
Provider Enumeration Date:
11/20/2008