Provider First Line Business Practice Location Address:
500 PLAZA CT STE B
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:
18301-8262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-517-2219
Provider Business Practice Location Address Fax Number:
570-421-0862
Provider Enumeration Date:
04/01/2008