Provider First Line Business Practice Location Address:
125 SCRANTON POCONO HWY
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:
18505-2274
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-963-2305
Provider Business Practice Location Address Fax Number:
570-963-2306
Provider Enumeration Date:
05/23/2007