Provider First Line Business Practice Location Address:
1011 SCRANTON CARBONDALE HWY STE 2
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:
18508-1127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-356-8265
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/09/2020