Provider First Line Business Practice Location Address:
13 SAINT JOHN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHUYLKILL HAVEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17972-1652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-385-8490
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2007