Provider First Line Business Practice Location Address:
46 CRYSTAL STREET
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:
18301-2809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-421-1908
Provider Business Practice Location Address Fax Number:
570-421-7056
Provider Enumeration Date:
03/30/2009