Provider First Line Business Practice Location Address:
400 PLAZA COURT
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
E STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-5555
Provider Business Practice Location Address Fax Number:
570-476-6108
Provider Enumeration Date:
07/28/2006