Provider First Line Business Practice Location Address:
732 PITTSTON AVE
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:
18505-4103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-346-1357
Provider Business Practice Location Address Fax Number:
570-346-3826
Provider Enumeration Date:
05/21/2007