Provider First Line Business Practice Location Address:
5699 RT 209
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:
18360-7161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-242-7718
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/19/2013