Provider First Line Business Practice Location Address:
1000 EAST MOUNTAIN BLVD. 2ND FLOOR
Provider Second Line Business Practice Location Address:
VALLEY MEDICAL BUILDING
Provider Business Practice Location Address City Name:
WILKES-BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-808-5751
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2026