Provider First Line Business Practice Location Address:
140 N 2ND ST UNIT 2
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:
18360-2528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-984-4700
Provider Business Practice Location Address Fax Number:
866-379-5580
Provider Enumeration Date:
07/08/2019