Provider First Line Business Practice Location Address:
441 WILKES BORRE TWP BLVD
Provider Second Line Business Practice Location Address:
SAMS CLUB OPTICAL
Provider Business Practice Location Address City Name:
WILKES BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-821-5513
Provider Business Practice Location Address Fax Number:
570-821-5514
Provider Enumeration Date:
04/30/2007