Provider First Line Business Practice Location Address:
700 E NORWEGIAN 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:
17901-2710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-621-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/16/2021