Provider First Line Business Practice Location Address:
800 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DICKSON CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18519-1544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-489-5161
Provider Business Practice Location Address Fax Number:
570-307-0730
Provider Enumeration Date:
11/14/2006