Provider First Line Business Practice Location Address:
241 CLAREMONT AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMETOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18252-4433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-225-7211
Provider Business Practice Location Address Fax Number:
570-225-7221
Provider Enumeration Date:
07/20/2005