Provider First Line Business Practice Location Address:
123 SUMNER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH ABINGTON TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18411-2223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-585-9822
Provider Business Practice Location Address Fax Number:
570-586-4218
Provider Enumeration Date:
11/16/2005