Provider First Line Business Practice Location Address:
1619 N 9TH ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18360-6501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-422-6500
Provider Business Practice Location Address Fax Number:
570-422-1010
Provider Enumeration Date:
08/02/2006