Provider First Line Business Practice Location Address:
225 S RIVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18705-1123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-655-0397
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/23/2008