Provider First Line Business Practice Location Address:
404 PARK AVE
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:
18360-1664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-234-0403
Provider Business Practice Location Address Fax Number:
570-234-3763
Provider Enumeration Date:
05/25/2014