Provider First Line Business Practice Location Address:
405 S STATE ST
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:
18411-1542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-586-4400
Provider Business Practice Location Address Fax Number:
570-587-5531
Provider Enumeration Date:
02/03/2006