Provider First Line Business Practice Location Address:
20 S RIVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18705-1213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-824-7242
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2011