Provider First Line Business Practice Location Address:
475 MORGAN HWY
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:
18508-2605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-961-2105
Provider Business Practice Location Address Fax Number:
570-969-4303
Provider Enumeration Date:
12/09/2014