Provider First Line Business Practice Location Address:
696 SCRANTON CARBONDALE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EYNON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18403-1004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-876-4488
Provider Business Practice Location Address Fax Number:
570-876-1625
Provider Enumeration Date:
11/29/2006