Provider First Line Business Practice Location Address:
727 W MARKET ST
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:
18508-1542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-344-6073
Provider Business Practice Location Address Fax Number:
570-348-5099
Provider Enumeration Date:
02/09/2007