Provider First Line Business Practice Location Address:
130 W 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERWICK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18603-4749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-579-5011
Provider Business Practice Location Address Fax Number:
570-579-5040
Provider Enumeration Date:
07/04/2006