Provider First Line Business Practice Location Address:
347 POTTSVILLE-ST. CLAIR HWY
Provider Second Line Business Practice Location Address:
SUITE 2
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:
570-622-8713
Provider Business Practice Location Address Fax Number:
570-622-8191
Provider Enumeration Date:
02/02/2007