Provider First Line Business Practice Location Address:
313 MULBERRY 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:
18503-1221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-346-7760
Provider Business Practice Location Address Fax Number:
570-346-9002
Provider Enumeration Date:
01/24/2007