Provider First Line Business Practice Location Address:
722 RT 6 AND 209
Provider Second Line Business Practice Location Address:
722 RT 6 AND 209
Provider Business Practice Location Address City Name:
MATAMORAS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
10963-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-491-5019
Provider Business Practice Location Address Fax Number:
570-491-5437
Provider Enumeration Date:
01/11/2008