Provider First Line Business Practice Location Address:
33 W CAREY 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:
18705-1524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-550-1913
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2021