Provider First Line Business Practice Location Address:
600 PLAZA COURT
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-8262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-5180
Provider Business Practice Location Address Fax Number:
866-309-4265
Provider Enumeration Date:
07/28/2006