Provider First Line Business Practice Location Address:
500 CENTRE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREELAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18224-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-636-2520
Provider Business Practice Location Address Fax Number:
570-636-1862
Provider Enumeration Date:
10/20/2006