Provider First Line Business Practice Location Address:
500 POTTSVILLE PARK PLZ
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:
17901-4104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-622-8150
Provider Business Practice Location Address Fax Number:
570-622-8193
Provider Enumeration Date:
07/09/2006