Provider First Line Business Practice Location Address:
71 N MOUNTAIN 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:
18707-1118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-474-9100
Provider Business Practice Location Address Fax Number:
570-474-9644
Provider Enumeration Date:
02/07/2007