Provider First Line Business Practice Location Address:
5 MORGAN HWY
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:
18508-2641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-558-7293
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2021