Provider First Line Business Practice Location Address:
600 LACKAWANNA AVE
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:
18503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-341-3636
Provider Business Practice Location Address Fax Number:
570-341-5046
Provider Enumeration Date:
11/02/2006