Provider First Line Business Practice Location Address:
414 E DRINKER ST
Provider Second Line Business Practice Location Address:
SUITE 101
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:
570-348-1757
Provider Business Practice Location Address Fax Number:
570-348-6721
Provider Enumeration Date:
06/01/2006