Provider First Line Business Practice Location Address:
364 N COURTLAND ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-1930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-730-4499
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/31/2016