Provider First Line Business Practice Location Address:
219 W GROVE ST LOWR LEVEL
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:
18411-2023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-319-0244
Provider Business Practice Location Address Fax Number:
570-338-4480
Provider Enumeration Date:
08/28/2014