Provider First Line Business Practice Location Address:
24 LENAPE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18302-8743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-898-0263
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/30/2009