Provider First Line Business Practice Location Address:
2000 ASH ST
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:
18510-1546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-241-3703
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2024