Provider First Line Business Practice Location Address:
505 INDEPENDENCE RD STE 2C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-7916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-395-2500
Provider Business Practice Location Address Fax Number:
570-395-2501
Provider Enumeration Date:
08/14/2019