Provider First Line Business Practice Location Address:
101 BROOKLYN STREET/BUSINESS ROUTE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARBONDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-282-4500
Provider Business Practice Location Address Fax Number:
570-281-7102
Provider Enumeration Date:
05/11/2009