Provider First Line Business Practice Location Address:
115 SPRING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKS GREEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18411-2511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-687-0120
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/28/2020