Provider First Line Business Practice Location Address:
1759 N KEYSER 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:
18508-1215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-961-1400
Provider Business Practice Location Address Fax Number:
570-961-0744
Provider Enumeration Date:
02/03/2012