Provider First Line Business Practice Location Address:
1 COUNTRY CLUB PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH ABINGTON TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18411-9199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-586-8990
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2010