Provider First Line Business Practice Location Address:
80 N. MOUNTAIN TOP BLVD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTAIN TOP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18707-1106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-822-8831
Provider Business Practice Location Address Fax Number:
570-820-7740
Provider Enumeration Date:
09/06/2006