Provider First Line Business Practice Location Address:
1803 W MAIN ST
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:
18360-1027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-421-0170
Provider Business Practice Location Address Fax Number:
570-424-5167
Provider Enumeration Date:
05/08/2006