Provider First Line Business Practice Location Address:
400 THE MALL AT STEAMTOWN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18503-2044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-892-9387
Provider Business Practice Location Address Fax Number:
570-342-6659
Provider Enumeration Date:
04/10/2026