Provider First Line Business Practice Location Address:
163 S RIVER 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:
18705-1120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-822-3040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/24/2021