Provider First Line Business Practice Location Address:
1233 N. 9TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18360-1172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-872-9222
Provider Business Practice Location Address Fax Number:
570-424-5664
Provider Enumeration Date:
04/17/2007