Provider First Line Business Practice Location Address:
1439 MONROE AVE STE 3
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:
18509-2497
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-963-1974
Provider Business Practice Location Address Fax Number:
570-963-0762
Provider Enumeration Date:
03/25/2008