Provider First Line Business Practice Location Address:
3540 WILKES BARRE
Provider Second Line Business Practice Location Address:
TOWNSHIP COMMONS
Provider Business Practice Location Address City Name:
WILKES BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-822-1800
Provider Business Practice Location Address Fax Number:
570-822-3600
Provider Enumeration Date:
07/05/2006