Provider First Line Business Practice Location Address:
73 SHAWNEE VLY
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:
18302-9354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-460-4330
Provider Business Practice Location Address Fax Number:
570-369-5073
Provider Enumeration Date:
05/26/2011