Provider First Line Business Practice Location Address:
441 WILKES-BARRE TOWNSHIP BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILKES-BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-824-6712
Provider Business Practice Location Address Fax Number:
570-824-7689
Provider Enumeration Date:
10/30/2020