Provider First Line Business Practice Location Address:
107 E CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AVIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17721-8904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-753-5403
Provider Business Practice Location Address Fax Number:
570-753-5485
Provider Enumeration Date:
09/18/2008