Provider First Line Business Practice Location Address:
760 SCRANTON CARBONDALE HWY
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:
18508-1112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-532-9456
Provider Business Practice Location Address Fax Number:
570-243-9361
Provider Enumeration Date:
06/29/2016