Provider First Line Business Practice Location Address:
183 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-5444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-718-6565
Provider Business Practice Location Address Fax Number:
570-714-8750
Provider Enumeration Date:
02/22/2006