Provider First Line Business Practice Location Address:
516 COURT ST
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:
18508-2281
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-558-7775
Provider Business Practice Location Address Fax Number:
570-558-7774
Provider Enumeration Date:
04/03/2007