Provider First Line Business Practice Location Address:
1545 N 9TH ST STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18360-6505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-234-0283
Provider Business Practice Location Address Fax Number:
570-290-8458
Provider Enumeration Date:
06/27/2006