Provider First Line Business Practice Location Address:
1464 ROUTE 61 HWY S
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:
17901-8408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-789-4608
Provider Business Practice Location Address Fax Number:
570-581-8089
Provider Enumeration Date:
06/03/2008