Provider First Line Business Practice Location Address:
16001606 NAY AUG AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-343-7940
Provider Business Practice Location Address Fax Number:
570-343-8827
Provider Enumeration Date:
07/07/2006