Provider First Line Business Practice Location Address:
298 W SOUTH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17724-1765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-673-5551
Provider Business Practice Location Address Fax Number:
570-673-5552
Provider Enumeration Date:
12/17/2008