Provider First Line Business Practice Location Address:
672 S RIVER ST STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18705-1034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-396-7334
Provider Business Practice Location Address Fax Number:
570-663-2382
Provider Enumeration Date:
03/08/2021