Provider First Line Business Practice Location Address:
2352 NEWTON RANSOM BLVD
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:
18411-9650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-388-2612
Provider Business Practice Location Address Fax Number:
570-388-0946
Provider Enumeration Date:
04/12/2006