Provider First Line Business Practice Location Address:
421 S STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKS SUMMIT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18411-1684
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-877-3140
Provider Business Practice Location Address Fax Number:
570-253-8242
Provider Enumeration Date:
05/10/2007