Provider First Line Business Practice Location Address:
100 PLAZA CT STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-8258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-6763
Provider Business Practice Location Address Fax Number:
570-424-9352
Provider Enumeration Date:
12/29/2006