Provider First Line Business Practice Location Address:
412 N. STATE ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKS SUMMIT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18411-1062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-586-0421
Provider Business Practice Location Address Fax Number:
570-586-5634
Provider Enumeration Date:
03/07/2007