Provider First Line Business Practice Location Address:
1100 CHURCH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONESDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18431-1943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-253-9200
Provider Business Practice Location Address Fax Number:
570-647-0268
Provider Enumeration Date:
08/27/2009