Provider First Line Business Practice Location Address:
100 PLAZA CT STE C
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-8258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-421-3800
Provider Business Practice Location Address Fax Number:
570-421-8014
Provider Enumeration Date:
05/23/2007