Provider First Line Business Practice Location Address:
1101 VINE ST
Provider Second Line Business Practice Location Address:
THERAPY DEPT
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18510-2126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-343-7175
Provider Business Practice Location Address Fax Number:
570-343-7175
Provider Enumeration Date:
05/16/2011