Provider First Line Business Practice Location Address:
1502 PITTSTON 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:
18505-1668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-346-7319
Provider Business Practice Location Address Fax Number:
570-343-5850
Provider Enumeration Date:
05/06/2024