Provider First Line Business Practice Location Address:
107 SOUTH MARKET STREET
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
BERWICK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-752-8753
Provider Business Practice Location Address Fax Number:
570-759-6372
Provider Enumeration Date:
04/03/2007