Provider First Line Business Practice Location Address:
INTERSTATE 81 & 901 W
Provider Second Line Business Practice Location Address:
FCI SCHUYLKILL
Provider Business Practice Location Address City Name:
MINERSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-334-4856
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2008