Provider First Line Business Practice Location Address:
693 MAIN ST STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW MILFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18834-7200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-465-2027
Provider Business Practice Location Address Fax Number:
570-465-2028
Provider Enumeration Date:
11/15/2006