Provider First Line Business Practice Location Address:
529 SEVEN BRIDGE RD UNIT 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-7608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-1768
Provider Business Practice Location Address Fax Number:
888-314-5032
Provider Enumeration Date:
04/13/2007