Provider First Line Business Practice Location Address:
208 LIFELINE RD STE 102
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:
18360-6473
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-420-5435
Provider Business Practice Location Address Fax Number:
570-420-5437
Provider Enumeration Date:
01/19/2007