Provider First Line Business Practice Location Address:
425 ADAMS AVE
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:
18510-2001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-558-3937
Provider Business Practice Location Address Fax Number:
570-558-1734
Provider Enumeration Date:
01/23/2007