Provider First Line Business Practice Location Address:
358 HAMLIN HWY, STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE ARIEL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-689-2449
Provider Business Practice Location Address Fax Number:
866-658-1522
Provider Enumeration Date:
03/06/2007