Provider First Line Business Practice Location Address:
534 WYOMING AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-287-5900
Provider Business Practice Location Address Fax Number:
570-287-6610
Provider Enumeration Date:
06/25/2006