Provider First Line Business Practice Location Address:
116 N WASHINGTON AVE STE 3340
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18503-1800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-903-5838
Provider Business Practice Location Address Fax Number:
570-330-4045
Provider Enumeration Date:
06/26/2025