Provider First Line Business Practice Location Address:
6381 LAKESHORE DR E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
E STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18302-8407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-242-7225
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/02/2026