Provider First Line Business Practice Location Address:
1619 N 9TH ST STE 9
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18360-6501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-664-8120
Provider Business Practice Location Address Fax Number:
570-664-8128
Provider Enumeration Date:
01/03/2016