Provider First Line Business Practice Location Address:
409 PROSPECT AVE
Provider Second Line Business Practice Location Address:
GROUND FLOOR
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18505-3366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-344-4234
Provider Business Practice Location Address Fax Number:
570-344-7332
Provider Enumeration Date:
05/19/2009