Provider First Line Business Practice Location Address:
1201 WHEELER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNMORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18510-1236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-343-0400
Provider Business Practice Location Address Fax Number:
570-342-5877
Provider Enumeration Date:
07/05/2005