Provider First Line Business Practice Location Address:
73 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUZERNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18709-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-283-0870
Provider Business Practice Location Address Fax Number:
570-338-3500
Provider Enumeration Date:
05/17/2023