Provider First Line Business Practice Location Address:
1544 ROUTE 61 HWY S STE 6145
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POTTSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17901-4219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-385-4201
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2006