Provider First Line Business Practice Location Address:
1000 MEADE ST
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
DUNMORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18512-3186
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-496-0300
Provider Business Practice Location Address Fax Number:
570-496-0303
Provider Enumeration Date:
07/05/2005