Provider First Line Business Practice Location Address:
516 FIG 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:
18505-1753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-207-2283
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2019