Provider First Line Business Practice Location Address:
1112A N 9TH 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:
18360-1102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-6005
Provider Business Practice Location Address Fax Number:
570-424-6534
Provider Enumeration Date:
07/10/2009