Provider First Line Business Practice Location Address:
125 SCRANTON POCONO 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:
18505-2274
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-963-2312
Provider Business Practice Location Address Fax Number:
570-963-2313
Provider Enumeration Date:
01/19/2006