Provider First Line Business Practice Location Address:
32/33 WYOMING VALLEY MALL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILKES-BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-819-1611
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2023