Provider First Line Business Practice Location Address:
575 EAST NORWEGIAN STREET
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:
570-622-2900
Provider Business Practice Location Address Fax Number:
570-622-7787
Provider Enumeration Date:
10/02/2006