Provider First Line Business Practice Location Address:
175 E BROWN ST
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
E STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-3098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-476-3585
Provider Business Practice Location Address Fax Number:
570-421-9014
Provider Enumeration Date:
03/21/2006