Provider First Line Business Practice Location Address:
341 JEFFERSON 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:
18510-2439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-347-5400
Provider Business Practice Location Address Fax Number:
570-342-0221
Provider Enumeration Date:
09/14/2006