Provider First Line Business Practice Location Address:
545 N RIVER ST STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILKES BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18702-2643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-706-8200
Provider Business Practice Location Address Fax Number:
570-707-8952
Provider Enumeration Date:
04/08/2013