Provider First Line Business Practice Location Address:
110 SCANLON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERWICK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18603-2501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-752-4747
Provider Business Practice Location Address Fax Number:
570-752-4747
Provider Enumeration Date:
09/27/2006