Provider First Line Business Practice Location Address:
695 E 16TH ST STE B
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:
18603-2320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-752-3640
Provider Business Practice Location Address Fax Number:
570-752-3425
Provider Enumeration Date:
08/16/2022