Provider First Line Business Practice Location Address:
104 SKINNER HILL RD
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:
18360-7505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-619-0080
Provider Business Practice Location Address Fax Number:
570-619-0082
Provider Enumeration Date:
03/05/2007