Provider First Line Business Practice Location Address:
204 SCOTT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLIFFORD TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18470-7564
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-507-7422
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2022