Provider First Line Business Practice Location Address:
SUITE 205
Provider Second Line Business Practice Location Address:
401 ADAMS AVENUE
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18510-2025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-344-6464
Provider Business Practice Location Address Fax Number:
570-344-0999
Provider Enumeration Date:
06/08/2006