Provider First Line Business Practice Location Address:
315 W MARKET ST
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:
17901-2928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-622-2777
Provider Business Practice Location Address Fax Number:
570-622-2683
Provider Enumeration Date:
03/14/2006