Provider First Line Business Practice Location Address:
425 N WASHINGTON AVE
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:
18503-1305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-348-3438
Provider Business Practice Location Address Fax Number:
570-348-3156
Provider Enumeration Date:
03/02/2007