Provider First Line Business Practice Location Address:
118 MONAHAN 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:
18512-1700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-344-5327
Provider Business Practice Location Address Fax Number:
570-342-1871
Provider Enumeration Date:
07/26/2018