Provider First Line Business Practice Location Address:
800 LINDEN ST
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:
18510-4694
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-941-6112
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2007