Provider First Line Business Practice Location Address:
672 S RIVER ST STE 101
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:
18705-1033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-552-7170
Provider Business Practice Location Address Fax Number:
570-552-7169
Provider Enumeration Date:
09/06/2013