Provider First Line Business Practice Location Address:
601 PARK ST
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:
18431-1445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-251-6676
Provider Business Practice Location Address Fax Number:
570-253-8425
Provider Enumeration Date:
09/02/2005