Provider First Line Business Practice Location Address:
102 N ABINGTON RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
CLARKS SUMMIT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18411-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-586-0246
Provider Business Practice Location Address Fax Number:
570-585-8970
Provider Enumeration Date:
12/08/2008