Provider First Line Business Practice Location Address:
5 MORGAN HWY STE 4
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:
18508-2641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-344-3788
Provider Business Practice Location Address Fax Number:
570-614-0212
Provider Enumeration Date:
06/28/2017