Provider First Line Business Practice Location Address:
1214 TEXAS PALMYRA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONESDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18431-7675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-253-6342
Provider Business Practice Location Address Fax Number:
570-253-0989
Provider Enumeration Date:
06/14/2007