Provider First Line Business Practice Location Address:
17382 STATE RTE 11
Provider Second Line Business Practice Location Address:
JOINES BLDG, SUITE 2
Provider Business Practice Location Address City Name:
NEW MILFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-465-9330
Provider Business Practice Location Address Fax Number:
570-465-9331
Provider Enumeration Date:
07/09/2006