Provider First Line Business Practice Location Address:
189 W MOUNTAIN TOP RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUMMIT HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18250-1758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-645-5394
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2013