Provider First Line Business Practice Location Address:
13 PARK LN
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:
18301-9095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-688-8489
Provider Business Practice Location Address Fax Number:
570-426-6873
Provider Enumeration Date:
11/02/2011