Provider First Line Business Practice Location Address:
40 S MOUNTAIN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTAIN TOP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18707-1123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-288-5800
Provider Business Practice Location Address Fax Number:
570-288-5900
Provider Enumeration Date:
05/16/2008