Provider First Line Business Practice Location Address:
414 E DRINKER ST STE 102
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:
18512-2469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-393-3183
Provider Business Practice Location Address Fax Number:
570-539-9702
Provider Enumeration Date:
11/21/2025