Provider First Line Business Practice Location Address:
1101 N 5TH ST
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:
18360-2659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-6928
Provider Business Practice Location Address Fax Number:
570-421-5472
Provider Enumeration Date:
01/20/2010