Provider First Line Business Practice Location Address:
157 SCRANTON CARBONDALE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EYNON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18403-1027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-230-0036
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/27/2012