Provider First Line Business Practice Location Address:
670 N RIVER ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18705-1027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-208-0150
Provider Business Practice Location Address Fax Number:
570-208-0154
Provider Enumeration Date:
02/26/2013