Provider First Line Business Practice Location Address:
100 SCHUYLKILL MEDICAL PLZ STE 203
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:
17901-3767
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:
570-621-5003
Provider Enumeration Date:
07/12/2006