Provider First Line Business Practice Location Address:
362 ST CLAIR HWY
Provider Second Line Business Practice Location Address:
RT 61 S
Provider Business Practice Location Address City Name:
POTTSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17901-3876
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-621-2020
Provider Business Practice Location Address Fax Number:
570-628-4933
Provider Enumeration Date:
03/30/2009