Provider First Line Business Practice Location Address:
105 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALLEY VIEW
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17983-9423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-682-8026
Provider Business Practice Location Address Fax Number:
570-682-8043
Provider Enumeration Date:
02/23/2006