Provider First Line Business Practice Location Address:
1401 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNMORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18509-1514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-348-6928
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2025