Provider First Line Business Practice Location Address:
292 FRANTZ RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18360-8356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-426-2900
Provider Business Practice Location Address Fax Number:
570-426-2929
Provider Enumeration Date:
07/22/2005