Provider First Line Business Practice Location Address:
1315 COLD SPRING RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18508-1113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-383-8731
Provider Business Practice Location Address Fax Number:
570-383-8740
Provider Enumeration Date:
08/21/2021