Provider First Line Business Practice Location Address:
425 SCRANTON/CARBONDALE HIGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DICKSON CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-558-6372
Provider Business Practice Location Address Fax Number:
570-558-9471
Provider Enumeration Date:
03/31/2006