Provider First Line Business Practice Location Address:
100 COMMUNITY DR STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOBYHANNA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18466-8987
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-476-2700
Provider Business Practice Location Address Fax Number:
570-895-4332
Provider Enumeration Date:
11/20/2023