Provider First Line Business Practice Location Address:
3306 LAKE ARIEL HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONESDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18431-7685
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-253-0148
Provider Business Practice Location Address Fax Number:
570-251-7816
Provider Enumeration Date:
01/10/2006