Provider First Line Business Practice Location Address:
128 N COURTLAND ST
Provider Second Line Business Practice Location Address:
RITE AID PHARMACY #00170
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-2104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-421-8665
Provider Business Practice Location Address Fax Number:
570-422-6591
Provider Enumeration Date:
02/23/2008