Provider First Line Business Practice Location Address:
1165 RED FOX RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-9106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-9660
Provider Business Practice Location Address Fax Number:
570-424-9661
Provider Enumeration Date:
09/09/2011