Provider First Line Business Practice Location Address:
390 PIERCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-5532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-288-3535
Provider Business Practice Location Address Fax Number:
570-288-0804
Provider Enumeration Date:
11/07/2006