Provider First Line Business Practice Location Address:
321 SPRUCE STREET
Provider Second Line Business Practice Location Address:
BANK TOWERS 4TH FLOOR
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-342-7582
Provider Business Practice Location Address Fax Number:
570-343-5162
Provider Enumeration Date:
09/11/2006