Provider First Line Business Practice Location Address:
650 PARK STREET
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-253-0202
Provider Business Practice Location Address Fax Number:
570-253-1701
Provider Enumeration Date:
08/29/2006