Provider First Line Business Practice Location Address:
312 N WASHINGTON AVE
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:
18503-1555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-343-1950
Provider Business Practice Location Address Fax Number:
570-343-1951
Provider Enumeration Date:
09/15/2014