Provider First Line Business Practice Location Address:
78 S COURTLAND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-2852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-7678
Provider Business Practice Location Address Fax Number:
570-424-7679
Provider Enumeration Date:
02/27/2019