Provider First Line Business Practice Location Address:
5122 MILFORD RD
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:
18302-9706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-223-2563
Provider Business Practice Location Address Fax Number:
570-223-1827
Provider Enumeration Date:
11/30/2020