Provider First Line Business Practice Location Address:
109 SEVEN BRIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-9100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-421-1254
Provider Business Practice Location Address Fax Number:
570-424-2346
Provider Enumeration Date:
06/13/2005