Provider First Line Business Practice Location Address:
575 N RIVER ST
Provider Second Line Business Practice Location Address:
7TH FLOOR
Provider Business Practice Location Address City Name:
WILKES BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18764-2634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-208-3310
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2014