Provider First Line Business Practice Location Address:
505 INDEPENDENCE RD STE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-7916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-382-3680
Provider Business Practice Location Address Fax Number:
215-240-1677
Provider Enumeration Date:
01/31/2012