Provider First Line Business Practice Location Address:
711 SCRANTON CARBONDALE HWY
Provider Second Line Business Practice Location Address:
SINIAWA PLAZA II
Provider Business Practice Location Address City Name:
DICKSON CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-558-1166
Provider Business Practice Location Address Fax Number:
570-558-1177
Provider Enumeration Date:
01/18/2006