Provider First Line Business Practice Location Address:
411 1/2 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18360-2486
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-476-6460
Provider Business Practice Location Address Fax Number:
570-476-6466
Provider Enumeration Date:
04/13/2006