Provider First Line Business Practice Location Address:
320 ADAMS AVE
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:
18503-1604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-348-6100
Provider Business Practice Location Address Fax Number:
570-706-2744
Provider Enumeration Date:
02/08/2007