Provider First Line Business Practice Location Address:
619 E DRINKER ST UNIT 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNMORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18512-2562
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-520-2400
Provider Business Practice Location Address Fax Number:
570-520-2500
Provider Enumeration Date:
08/28/2020