Provider First Line Business Practice Location Address:
203 OAKFORD RD
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:
18411-9244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-586-5003
Provider Business Practice Location Address Fax Number:
570-585-7935
Provider Enumeration Date:
09/02/2006