Provider First Line Business Practice Location Address:
272 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW MILFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-465-5000
Provider Business Practice Location Address Fax Number:
570-465-5000
Provider Enumeration Date:
08/14/2006