Provider First Line Business Practice Location Address:
1027 MONTDALE ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTT TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18447-9785
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-254-6666
Provider Business Practice Location Address Fax Number:
570-254-6138
Provider Enumeration Date:
06/22/2006