Provider First Line Business Practice Location Address:
1800 N WASHINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18509-1700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-963-4666
Provider Business Practice Location Address Fax Number:
579-963-4544
Provider Enumeration Date:
01/06/2009