Provider First Line Business Practice Location Address:
179 INDEPENDENCE RD FL 2
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:
18301-9207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-421-3900
Provider Business Practice Location Address Fax Number:
570-476-6108
Provider Enumeration Date:
06/13/2018