Provider First Line Business Practice Location Address:
1200 FREAS AVE
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:
18603-1612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-752-6441
Provider Business Practice Location Address Fax Number:
570-752-6442
Provider Enumeration Date:
02/17/2006