Provider First Line Business Practice Location Address:
128 W MARKET 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:
18508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-347-1177
Provider Business Practice Location Address Fax Number:
570-347-4691
Provider Enumeration Date:
07/17/2014