Provider First Line Business Practice Location Address:
201 N MAIN ST
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:
18705-1509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-283-3222
Provider Business Practice Location Address Fax Number:
877-231-0567
Provider Enumeration Date:
10/10/2018