Provider First Line Business Practice Location Address:
37 HONESDALE RD
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:
18407-1431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-282-2456
Provider Business Practice Location Address Fax Number:
570-282-9114
Provider Enumeration Date:
02/03/2006