Provider First Line Business Practice Location Address:
1 STADIUM DRIVE
Provider Second Line Business Practice Location Address:
SCRANTON
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-598-4800
Provider Business Practice Location Address Fax Number:
304-293-6963
Provider Enumeration Date:
08/15/2006