Provider First Line Business Practice Location Address:
310 ADAMS AVE
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:
18503-1620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-343-2448
Provider Business Practice Location Address Fax Number:
570-207-6368
Provider Enumeration Date:
09/16/2006