Provider First Line Business Practice Location Address:
1148 W MAIN 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:
18360-1323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-420-4135
Provider Business Practice Location Address Fax Number:
570-420-4138
Provider Enumeration Date:
06/17/2015