Provider First Line Business Practice Location Address:
135 HONEY POT STREET - REAR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NANTICOKE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18634-1541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-933-2861
Provider Business Practice Location Address Fax Number:
570-276-2098
Provider Enumeration Date:
05/10/2011