Provider First Line Business Practice Location Address:
175 E BROWN ST
Provider Second Line Business Practice Location Address:
SUITE 114
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-3098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-421-3908
Provider Business Practice Location Address Fax Number:
570-421-5912
Provider Enumeration Date:
08/22/2006