Provider First Line Business Practice Location Address:
601 WYOMING AVE
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:
18704-3701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-283-2040
Provider Business Practice Location Address Fax Number:
570-280-2032
Provider Enumeration Date:
04/23/2007