Provider First Line Business Practice Location Address:
411 MAIN ST
Provider Second Line Business Practice Location Address:
100A
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18360-2499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-420-9777
Provider Business Practice Location Address Fax Number:
570-420-9780
Provider Enumeration Date:
10/04/2010