Provider First Line Business Practice Location Address:
1419 N 9TH ST
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:
18360-7574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-7644
Provider Business Practice Location Address Fax Number:
570-476-9849
Provider Enumeration Date:
11/02/2012