Provider First Line Business Practice Location Address:
100 SCHUYLKILL MEDICAL PLZ
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
POTTSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17901-3663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-621-5005
Provider Business Practice Location Address Fax Number:
570-628-2525
Provider Enumeration Date:
01/11/2008