Provider First Line Business Practice Location Address:
596 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHUMBERLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17857-1262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-473-1200
Provider Business Practice Location Address Fax Number:
570-473-3300
Provider Enumeration Date:
10/07/2020