Provider First Line Business Practice Location Address:
415 ADAMS AVENUE
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:
18510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-504-8100
Provider Business Practice Location Address Fax Number:
570-504-8106
Provider Enumeration Date:
12/01/2006