Provider First Line Business Practice Location Address:
629 E DRINKER ST STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNMORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18512-2549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-209-5981
Provider Business Practice Location Address Fax Number:
570-796-7336
Provider Enumeration Date:
07/20/2019