Provider First Line Business Practice Location Address:
670 N RIVER ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18705-1027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-208-2787
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2006