Provider First Line Business Practice Location Address:
1095 TEXAS PALMYRA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONESDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18431-7687
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-253-4000
Provider Business Practice Location Address Fax Number:
570-253-8977
Provider Enumeration Date:
02/02/2009