Provider First Line Business Practice Location Address:
105 DESMOND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAYRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18840-2001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-887-3144
Provider Business Practice Location Address Fax Number:
570-887-3029
Provider Enumeration Date:
03/24/2018