Provider First Line Business Practice Location Address:
202-204 S. CENTRE ST.
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-628-5835
Provider Business Practice Location Address Fax Number:
610-628-5838
Provider Enumeration Date:
02/05/2007