Provider First Line Business Practice Location Address:
1020 W LACKAWANNA AVE STE 380
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:
18504-2052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-904-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/01/2020