Provider First Line Business Practice Location Address:
1800 MULBERRY ST.
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:
18510-6800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-703-8151
Provider Business Practice Location Address Fax Number:
570-703-8387
Provider Enumeration Date:
08/01/2006