Provider First Line Business Practice Location Address:
3202 LAKE ARIEL HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONESDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18431-7602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-616-1964
Provider Business Practice Location Address Fax Number:
570-251-6570
Provider Enumeration Date:
08/28/2026