Provider First Line Business Practice Location Address:
60 EAGLEVILLE ROAD
Provider Second Line Business Practice Location Address:
MONTGOMERY COUNTY CORRECTIONAL FACILITY
Provider Business Practice Location Address City Name:
EAGLEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19403-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-635-7100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2006