Provider First Line Business Practice Location Address:
1860 FAIR AVE STE A
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:
570-253-3391
Provider Business Practice Location Address Fax Number:
570-253-1811
Provider Enumeration Date:
10/22/2007