Provider First Line Business Practice Location Address:
1619 N. 9TH STREET
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-426-1868
Provider Business Practice Location Address Fax Number:
570-426-1867
Provider Enumeration Date:
03/31/2008