Provider First Line Business Practice Location Address:
1130 6TH AVE STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERWICK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-759-9986
Provider Business Practice Location Address Fax Number:
570-759-9266
Provider Enumeration Date:
06/06/2006